Hepatitis: The Silent Epidemic

On July 28th every year, we recognise World Hepatitis Day. This annual event is used to raise the awareness of this disease as well as prevention, treatment and testing. This year Swindon has luckily been picked out, along with 7 other towns & cities across the UK, for a specialised Hepatitis roadshow.

There are an estimated 519 people in the Swindon area who have hepatitis C, less than half of these are likely to have been diagnosed and only approximately 3 per cent of those living with the virus receive treatment each year. 45.5% of hospital admissions for hepatitis C were unplanned in the Swindon area (2011-2012). The Hepatitis C: Talk, Test, Treat roadshow will be located at Canal Walk crossroads with Regent and Bridge Streets, near the Brunel Shopping Centre, SN1 1BB, from 10am-4pm July 18th, acting as a build up to World Hepatitis Day on the 28th.

Charles Gore, Chief Executive of The Hepatitis C Trust said: "Our World Hepatitis Day message is clear: if you think you have ever been at risk of hepatitis C, get tested. It can save your life. The Hepatitis C: Talk, Test, Treat roadshow will visit areas across England and Wales where there is real need to encourage testing and raise awareness. Prioritising the condition locally will contribute to our aim to eradicate the virus within a generation.

"People are needlessly dying from this preventable and curable disease because they simply don't know they have it. What a waste of lives; and it's also a waste of money. If the health service can't see the human imperative of increasing testing, they should at least be able to understand the economic case."

Laura Hill, Community Health Adviser, from Sexual Health, The Great Western Hospital, comments, "It is common that many people live with hepatitis C without ever realising because they often don't have symptoms. Treatment is much more difficult if the disease is caught late and therefore it's imperative that we diagnose people as early as possible to maximise the chance of a cure. I am a strong believer in screening as many people as we can, so localised events like this roadshow are incredibly important. The virus is transmitted through blood-to-blood contact. Anyone who considers themselves to have ever been at risk should come down to the Swindon event."

At each event, representatives from The Hepatitis C Trust, British Liver Trust, Crime Reduction Initiatives, Addiction and local patient support groups will be on hand to answer questions and provide information. Members of the public will be able to undertake a hepatitis C risk screener to help determine whether they may be at risk. They can then receive immediate confidential testing on site, to see if they need to take any further action.

Professor Graham Foster comments, "This is an exciting time for hepatitis C. Current treatments can cure over 70% of patients with early disease and there are many new drug treatments on the horizon that are likely to improve success rates still further. Treatment is much more difficult if the disease is caught late and therefore it's imperative that we diagnose those with hepatitis C as early as possible to maximise the chance of a cure. I am a strong believer in screening and testing as many people as we can. Localised events like this roadshow play an important role in identifying patients."

The Men's Sexual Health team will be attending the event and will be on hand to offer advice and support to anyone visiting the Swindon roadshow. Once the roadshow has left the area, we want to ensure anyone diagnosed is supported after the event and signposted to the local Hep C support group. We have worked closely with the members of this group in the run up to this campaign, hearing their stories and thoughts about living with Hepatitis.

This year the World Hepatitis Alliance overall theme for World Hepatitis Day 2013 is See no evil, speak no evil, hear no evil, as represented by the three wise monkeys, an old proverb that is commonly used to highlight how people often deal with problems by refusing to acknowledge them. The monkeys have been chosen for our campaign to highlight the fact that hepatitis is still largely being ignored on a global scale. We are calling for people to uncover their senses and confront the realities of hepatitis.

It is currently estimated 500,000 people in the UK are living with some form of Hepatitis (compared to 90,000 living with HIV), and 500 million worldwide (34 million HIV worldwide), that is shockingly 1 in 12 people! The reason for the HIV comparison is that compared to HIV, very little awareness occurs for Hepatitis and the majority of people carrying the disease are unaware. That is why we hope that World Hepatitis Day will prompt people to think about the huge scale of viral hepatitis infection globally, about whether they may be at risk (and if so, to get tested) and also about how to avoid becoming infected.

Together hepatitis B and C represent one of the major threats to global health. Hepatitis B and C are both silent viruses, and because many people feel no symptoms, you could be infected for years without knowing it. If left untreated, both the hepatitis B and C viruses can lead to liver scarring (cirrhosis). If you have liver cirrhosis, you have a risk of life-threatening complications such as bleeding, ascites (accumulation of fluid in the abdominal cavity), coma, liver cancer, liver failure and death. In the case of chronic hepatitis B, liver cancer might even appear before you have developed cirrhosis.

In some cases, a diagnosis is made too late and the only option is a liver transplant. If you think you have been at risk, it is important that you get tested as soon as possible and, if diagnosed, consider your treatment options and self-management strategies.

Patients with hepatitis B infection can also be infected with a second virus known as hepatitis delta virus, hepatitis D virus or simply HDV.

The Difference between Hepatitis B and C

• While there is a vaccine that protects against hepatitis B infection, there is no vaccine available for hepatitis C
• Both viruses can be contracted though blood-to-blood contact
• Hepatitis B is more infectious than hepatitis C and can also be spread through saliva, semen and vaginal fluid
• In the case of hepatitis B, infection can occur through having unprotected sex with an infected person. Please note that this is much rarer in the case of hepatitis C
• While unlikely, it is possible to contract hepatitis B through kissing. You cannot contract hepatitis C through kissing
• Neither virus is easily spread through everyday contact. You cannot get infected with hepatitis B or C by shaking hands, coughing or sneezing, or by using the same toilet. There are different treatments for the two viruses. While treatment can control chronic hepatitis B, it can often cure hepatitis C
• Even if treatment is not an option for you, you can do something about your disease. A healthy lifestyle is important. Alcohol, smoking, eating fatty foods, being overweight or extreme dieting (eating no food at all) may worsen your liver disease.  Therefore, try to avoid all alcohol, stop smoking, eat a low fat diet with enough fruit and vegetables, and reduce your weight if necessary

Hepatitis B

The World Health Organisation (WHO) recognises that hepatitis B is one of the major diseases affecting mankind today. Hepatitis B is one of the most common viral infections in the world and the WHO estimates that two billion people have been infected with the hepatitis B virus and approximately 350 million people are living with chronic (lifelong) infections. 500,000 - 700,000 people die every year from hepatitis B.

The hepatitis B virus is highly infectious and about 50 - 100 times more infectious than HIV. In nine out of ten adults, acute hepatitis B infection will go away on its own in the first six months. However, if the virus becomes chronic, it may cause liver cirrhosis and liver cancer after up to 40 years, but in some cases as little as five years after diagnosis.

The hepatitis B virus is transmitted between people through contact with the blood or other body fluids (i.e. saliva, semen and vaginal fluid) of an infected person. Although not all people will have any signs of the virus, those that do may experience the following symptoms:

• Flu-like symptoms
• Fatigue
• Nausea
• Jaundice (yellowing of the skin)
• Stomach ache
• Diarrhoea/dark urine/bright stools
• Aching joints

Unlike hepatitis C, there is a vaccine that can prevent infection. If you think you are at risk, you should get vaccinated as soon as possible.

Hepatitis C

Hepatitis C is different from hepatitis B in that the virus more frequently stays in the body for longer than six months, and therefore becomes chronic. Four out of five people develop a chronic infection, which may cause cirrhosis and liver cancer after 15 - 30 years. There are approximately 170 million people chronically infected with hepatitis C worldwide. In 2000, the WHO estimated that between three and four million people are newly infected every year.

Hepatitis C is mainly spread through blood-to-blood contact and, similarly to hepatitis B, there are often no symptoms but if they are present can include:

• Flu-like symptoms
• Fatigue
• Nausea
• Aching muscles and joints
• Anxiety and depression
• Poor concentration
• Stomach ache
• Loss of appetite
• Dark urine/bright stools

So please support this world wide health campaign: click on one of our posters, print it off and display it at your place of work. Come along on Thursday July 18th to the Swindon Road Show, or if you are interested in attending the Hep C Swindon Support Group, which is open to anyone with Hep C, partners of, or professionals, it is every Monday 6.30pm-8.30pm at Broadgreen Community Centre, Swindon, contact hepcpositive@swads.org.uk or phone 07580 025116.

Published: 15th July 2013 by Matt (updated Thu 21st Jan)