Hepatitis C, a viral disease that affects the liver, is four times more common than the HIV virus. Around the world, 170 million people are infected with it. Between 20,000 and 50,000 people in the Republic of Ireland are estimated to have hepatitis C infection – but more than half of those don’t know they have it. Up to 1,000 new cases are identified each year.
The late stage of the disease causes irreversible liver damage. In the early stages, however, two-thirds of people don’t experience any symptoms and don’t realise they have the virus.
Many of those infected are not diagnosed until they have more serious symptoms, such as cirrhosis, or scarring, of the liver. Those people are at a higher risk of developing liver cancer.
Hepatitis C is transmitted through blood-to-blood contact. It is also possible to contract the disease through medical and dental procedures, piercings, tattoos and acupuncture, if the instruments aren’t properly sterilised. The disease can be sexually transmitted. It can also pass from mother to child during pregnancy and birth.
Community Response, an alcohol and hepatitis support service in Dublin, and the Janssen pharmaceutical company, have launched a campaign to raise awareness of the disease and highlight the need to fund the Health Service Executive’s National Hepatitis C Strategy. The campaign organisers urge anyone who may be at risk of hepatitis C to seek help and get tested.
Lawrence’s story
Lawrence Murphy, who had hepatitis C for more than 10 years before he received treatment, has avoided the more serious symptoms of the illness. His liver is mildly scarred, but it could have been worse.
In the 1990s, Murphy contracted the disease through intravenous drug use, but didn’t know he had it until he was tested at a methadone clinic in 2002. He first went for treatment in 2010, a year after he had kicked his drug habit. The doctor who diagnosed Murphy gave him a pamphlet with information about the disease.
“I didn’t really understand what it was. I didn’t think it was that severe. I thought it wouldn’t be that bad. I was left to my own devices,” he says. He had some mild flu-like symptoms and aches and pains over the years, but he didn’t attribute them to hepatitis C.
Before he sought treatment, he put the diagnosis to the back of his mind, but sometimes he thought about it while brushing his teeth. The doctor had warned that sharing toothbrushes and razors could transmit the virus, as they might have blood on them. According to Dr Shay Keating, who works with the National Drug Treatment Centre and St James's Hospital, about 2,000 people contracted hepatitis C through contaminated blood products within the State decades ago. Those people are entitled to a range of medical support services.
But the vast majority of hepatitis C sufferers – 80 per cent in Ireland – contracted it via intravenous drug use by sharing needles and paraphernalia.
Keating, who works with hepatitis C patients, says it is a very robust virus that can live for up to four days outside the body, so it’s very easy to pass on via needle-stick injury. He notes a worrying trend: people who did drugs briefly 20 or 30 years ago and are now married with kids might not place a hepatitis C test high on their agenda. But it’s important that they get tested.
A treatable illness
Keating says hepatitis C is a very treatable illness, and it’s crucial that people know when they are affected to avoid chronic liver disease. It’s one of the few viruses that can be cured, which is a relatively recent development.
In April, The Irish Times reported that new drug treatments offered a cure rate of about 95 per cent, and would be available in Ireland within the year.
But the new drug is pricey. Sovaldi has been approved in the US at the cost of $84,000 (€63,000) per patient. Janssen, co-sponsor of the awareness campaign, manufactures Olysio, a similar drug.
Sovaldi and Olysio are not generally available in Ireland, but they should be by the end of the year. Keating says all treatment is provided through the public health system, but there is a shortage of doctors and nurses to administer treatment and a lack of funding.
Murphy has been undergoing treatment for 42 weeks and has two weeks left. The treatment consists of daily injections and tablets.
During his treatment, Murphy worked and got a degree in addiction support and community development.
He now works at Community Response, helping people who are struggling with the disease.
“I try to give people some facts and information, because I didn’t have any at the start,” he said.
As part of the awareness campaign, Community Response invites people to petition their local TDs to ensure that resourcing the National Hepatitis C Strategy is a priority in Budget 2015. See communityresponse.ie