Hepatitis: The Silent Killer

Published: Mon 25 Jul 2011 02:24 PM
Hepatitis: The Silent Killer
World Hepatitis Day 28 July 2011
Auckland – 25 July 2011 - More than 250 New Zealanders die prematurely and unnecessarily each year due to viral hepatitis. And it is estimated that the number of New Zealanders with chronic viral hepatitis who die from either liver cancer or liver failure will treble over the next two decades. This comes at an enormous cost to New Zealand – more than $400 million by 2020 for hepatitis C alone.
Many people are completely unaware that they have hepatitis. Often those in the early stages of both chronic hepatitis B and hepatitis C have no discernible symptoms. Both hepatitis B and hepatitis C can be successfully treated to halt the disease and in many cases reverse the cirrhosis damage (scarring of the liver) which may lead to liver cancer or liver failure.
Antiviral treatment for hepatitis is fully-funded and effective. The good news is that if people at risk of hepatitis B and C are screened, diagnosed, enrolled into follow-up and successfully treated, their life expectancy and quality of life will be the same as someone who is not infected with hepatitis B or C. However, low testing and diagnosis rates mean that only 10 percent of all New Zealanders with viral hepatitis have been diagnosed and less than 5 percent have been successfully cured.
Associate Professor Ed Gane, chief hepatologist at the New Zealand Liver Transplant Unit at Auckland City Hospital, says viral hepatitis is thought to be responsible for more than 90 percent of liver cancer cases in New Zealand and more than 60 percent of adult liver transplants.
“We need to dramatically increase the number of New Zealanders who receive antiviral treatment for their disease to mitigate this health and financial burden.
“For this to happen we need to increase public awareness of both the risk factors associated with chronic hepatitis B and hepatitis C infection and the lifestyle factors associated with disease progression such as obesity, heavy alcohol or cannabis use,” says Professor Gane.
“Too often we don’t see patients until they present with symptoms from advanced disease when it is no longer curable.”
John Hornell, CEO of the Hepatitis Foundation of New Zealand, says World Hepatitis Day, which has the support of the World Health Organisation, is an opportunity to raise awareness of the disease amongst the New Zealand public and politicians.
“The theme of World Hepatitis Day this year is ‘Know it. Confront it’. We want people who think they may be at risk or infected to get tested, it’s a simple blood test; get diagnosed, enrol into follow-up and get treated.
“Hepatitis is preventable. Get immunised against hepatitis B. Take precautions: practice safe sex; use sterile injecting equipment; don’t share razors, toothbrushes or drug-taking equipment.”
All Asian, Pacific and Maori New Zealanders should be tested for hepatitis B.
All New Zealanders who answer yes to one of the following six questions should be tested for hepatitis C.
1. Have you received a blood transfusion either in New Zealand prior to 1992 or at any time overseas?
2. Have you ever experimented with injecting drugs?
3. Have you ever been jaundiced or diagnosed with hepatitis?
4. Have you ever been told that you had abnormal liver function?
5. Have you ever lived in or received health care in South East Asia, Indian subcontinent, Middle East, or Eastern Europe?
6. Have you ever been in prison?
Any person answering yes to any of these questions should be tested.
About hepatitis B
Approximately 100,000 New Zealanders have chronic hepatitis B. New Zealand Maori, Pacifica and Asian populations have high rates of hepatitis B infection. Most chronic infections occur at birth or in early childhood.
While most people with hepatitis B don’t experience symptoms, they can be mild to severe and can include abdominal pain, dark urine, joint pain, loss of appetite, nausea and vomiting, weakness and fatigue and yellowing of the skin and the whites of the eyes (jaundice)
Hepatitis B risk factors:
• Maori, Pacific or Asian ethnicity
• Immigration from Asia and the Pacific
• Family member with hepatitis B
• Sexual partner with hepatitis B
If a person with hepatitis B has cirrhosis, their risk of developing liver cancer increases 100-fold.
The neonatal vaccination programme introduced in 1987 has been very successful. Vaccination rates are good, so there are few hepatitis cases amongst children born in New Zealand.
About hepatitis C
It is estimated that there are 50,000 people in New Zealand with chronic hepatitis C. Most infections occur through blood-to-blood transmission, the most common cause being recreational drug use.
Hepatitis C risk factors:
• Recreational injecting drug use
• Previous/current imprisonment
• Tattoo or body piercing
• Blood transfusion prior to 1992
In 90 percent of hepatitis C cases the cause is recreational injecting drug use. The number of people with hepatitis C is not growing, but the group is getting older and the proportion with cirrhosis complications is climbing steadily (both internationally and in New Zealand). People developing symptoms now were usually infected in the 1970s and 80s.
In 2000, only five New Zealanders were diagnosed with hepatitis C-related liver cancer. In 2010 this number was greater than 60.
World Hepatitis Day is 28 July 2011.

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