Healthy Living in the North

World Hepatitis Day: What you need to know

Graphic image of head with virus images in top right corner.

For World Hepatitis Day, Andrew Burton created a graphic image titled “Hepatitis on my Mind”. What can you do to prevent hepatitis?

July 28 is World Hepatitis Day. It’s an important day to remind us all to take care of our bodies!

Hepatitis is a group of diseases that affect the liver. The liver is the largest organ inside the body and one that most of us take for granted. Your liver cleans away toxins, fights infections and helps to digest food. It’s a strong and resilient organ. Most of the time it can heal itself but some things can seriously harm it.

Hepatitis, alcohol and some drugs can damage the liver, creating scarring called fibrosis that can lead to cirrhosis, liver cancer and liver failure. The Public Health Agency of Canada predicts that by 2027, deaths related to cirrhosis and liver cancer will increase by 27 per cent.

There are seven identified types of viral hepatitis with types A, B and C being most common. You can be immunized against hepatitis A and B, but not C.

Hepatitis C (HCV) is the leading cause of liver transplants. About 80 per cent of people who have the acute form of HCV show no noticeable symptoms. HCV can live and grow in the body for years without being noticed until serious harm has been done. HCV can also be a co-infection with other illnesses, such as HIV or hepatitis A or B, that make the damage worse.

HCV is spread by blood-to-blood contact such as sharing drug-using equipment; reusing tools in tattooing, body piercing, acupuncture and electrolysis; sharing items that have blood on them like toothbrushes, razors or nail clippers; and unprotected sex where blood could be present.

The only way to really know if you have HCV is to get tested. A simple blood test can tell you if you have come in contact with the virus.

There is some good news about HCV: it is curable. Treatment can eliminate the infection from the body. Knowing your HCV status is the first step. Take that step. Get tested.

Ask yourself what you do now that could put you at risk. Where you see risk factors, make some changes. We all have room to lead healthier lives!

Andrew Burton

About Andrew Burton

Andrew is a Community Integration Systems Navigator for Northern Health’s HIV and Hepatitis C Care team and works to support healthy living practices in communities across northern B.C. Andrew is developing positive activity and diet practices for two reasons: to deal with his own health concerns, and to “walk the talk” of promoting healthy living. Building on his training and experience in creative arts therapy, Andrew founded and runs the Street Spirits Theatre program promoting social responsibility among young people. This work has been recognized nationally and internationally as a leading method of social change.

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Taking aim at stigma: Northern Health offers routine HIV testing to everyone

Northern Health staff person stands in front of a display board for HIV project

As a member of the Blood Borne Pathogens team, Sam Milligan provides HIV/HCV education and consultation services to regional Northern Health programs and communities.

Northern Health is taking steps to reduce the stigma around HIV by introducing routine HIV testing for everyone, not just people at risk.

In addition to current risk-based testing guidelines, Northern Health has adapted the 2014 HIV testing guidelines developed by the British Columbia Office of the Provincial Health Officer. These guidelines recommend that everyone between 18 to 70 years of age, in both acute care settings and the community, be offered an HIV test every five years as part of routine health screening.

Preceding the release of the 2014 HIV testing guidelines, the University Hospital of Northern BC initiated the routine offer of HIV screening in December 2013 to all admitted patients who are having blood work taken for another reason while admitted.

“The Public Health Agency of Canada estimated in 2011 that approximately 25 per cent of people living with HIV in Canada are unaware of their HIV-positive status. Evidence also suggests that this 25 per cent account for up to 70 per cent of all new HIV infections,” says Bareilly Sweet, Northern Health’s Regional Coordinator, Blood Borne Pathogens Services.

“We also know that nearly 55 per cent of new HIV diagnoses in Northern Health are diagnosed late, with close to 20 per cent of new diagnoses fitting the criteria for advanced HIV. This means that over half of the people living within Northern Health’s region should already be on HIV treatment at the time of their HIV diagnosis.”

Historically, the reason for an HIV test has fallen into two categories: routine testing for women during pregnancy, and voluntary testing for everyone else. The problem lays in the second option — voluntary testing. For voluntary testing to occur, two conditions have to be met:

  • Health care providers need to ask their clients about risk and risk-related behaviour; however, current research evidence suggests such conversations are very difficult for health care providers to initiate with patients; and
  • Patients need to know they are at risk, recognize that risk, and be willing to disclose risk to their health care provider.

“Unfortunately, the current testing criterion stigmatizes testing. This discourages clinicians from offering an HIV test and discourages patients from seeking and/or accepting an HIV test,” says Sweet. “But that won’t stop us from continuing our work to normalize HIV testing, because routine testing will catch HIV infections in the early stages. And that’s what we need to do, because then we can improve the patient experience on every step of the HIV journey.”

St. John Hospital in Vanderhoof, Stuart Lake Hospital in Fort St. James and the Fraser Lake Health Centre began implementing the routine offer of HIV testing in the spring of 2014. Lakes District Hospital and Health Centre in Burns Lake and GR Baker Hospital in Quesnel are in the preparatory stages to begin offering HIV testing.

This article was originally published in September 2014 in Northern Health’s new internal magazine.

Sam Milligan

About Sam Milligan

Sam is the regional health systems navigator in Northern Health’s blood borne pathogens (BBP) services team. In his role, he provides education and consultation services to communities and programs across the north. Some of his responsibilities include improving community access to HIV & HCV treatment, increase testing for HIV/HCV, and provide current practice education to staff, physicians, and community members. If not at work or talking about work, Sam can be found in the realms of adventures with his two young sons or hanging out with the most gorgeous woman on the planet: his wife. (Sam no longer works with Northern Health, we wish him all the best.)

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World Hepatitis Day 2014: Learn the facts about Hepatitis C

blood test, Heptatitis C

You take a simple blood test to test for HCV.

Monday, July 28th was World Hepatitis Day, so Northern Health would like to take this opportunity to share some important information about this chronic disease.

Hepatitis is an inflammation of the liver. There are many types of hepatitis viruses: hepatitis A, B, C, D, and E, with more likely to be confirmed. The most common types in British Columbia are hepatitis A, B, and C.

Hepatitis C (HCV) is the most common of these three, so let’s focus on it.

From 1995-2012, there were 4,277 cases of HCV infections reported across Northern Health, with men accounting for 63 per cent of those cases. In 2012, there were 122 new cases of HCV in Northern Health — 67 per cent were men. The groups with the highest rates of infection are men aged 40-59 and women aged 25-29 and 40-59. Northern Health HCV prevalence in 2012 was 43.8 infections per 100,000 people, just above the provincial prevalence of 40.8 per 100,000.

How is HCV spread?
HCV is spread by direct contact with the blood of an infected person, through sharing injection drug equipment and other drug use paraphernalia, accidental exposure through needle sticks, and, prior to 1990, blood transfusions. Low risk activities for HCV exposure include skin-piercing procedures with non-sterile equipment, sexual intercourse, and prenatal transmission.

What are the symptoms of HCV?
Common symptoms include fever, tiredness, jaundice (yellow skin or eyes), abdominal pain, dark urine, loss of appetite and nausea. Some people living with HCV feel fine and have no symptoms, but HCV can be a life-threatening disease so it’s important to know your status.

IS HCV treatable?
YES! For some people who get HCV, the virus disappears on its own, usually within the first six months of infection. However, for most people, the HCV virus does not go away. Treatment is available, with cure rates of up to 80 per cent for certain genotypes. What’s a genotype? It’s the genetic makeup of the virus and, for HCV, there are six distinct genotypes. Some of them have subgroups — so it’s best to ask your physician for more details.

How do I test for HCV?
You take a simple blood test for HCV, much like the HIV test. So if you’re offered an HIV test by your physician, don’t hesitate to request the HCV test, too.

For more information, please visit HepCBC at hepcbc.ca.

Did you do anything on Monday to raise awareness about Hepatitis?

Sam Milligan

About Sam Milligan

Sam is the regional health systems navigator in Northern Health’s blood borne pathogens (BBP) services team. In his role, he provides education and consultation services to communities and programs across the north. Some of his responsibilities include improving community access to HIV & HCV treatment, increase testing for HIV/HCV, and provide current practice education to staff, physicians, and community members. If not at work or talking about work, Sam can be found in the realms of adventures with his two young sons or hanging out with the most gorgeous woman on the planet: his wife. (Sam no longer works with Northern Health, we wish him all the best.)

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