World Hepatitis Day: we could eliminate hepatitis C in the UK - but only half of those infected know they have it

Almost half of people who inject drugs have hepatitis C. Sharing straws or notes for snorting cocaine also puts people at risk. It's time to raise awareness

400 million people are living with viral hepatitis and it kills 1.45 million people each year. It is now the number one infectious disease killer, ahead of HIV/AIDS, TB or malaria, according to just published data in The Lancet. One of the reasons for this is the huge priority, backed by enormous resources, that has been directed at the other three major infectious diseases and the consequent impressive drop in the mortality they cause.

The other reason is that almost nothing has been done to tackle viral hepatitis. Finally in 2010 the World Health Organization (WHO) created, through its first resolution on hepatitis, an official World Hepatitis Day on July 28, recognising that in no other disease area is there such a huge gap between the burden and the level of awareness.  Then, this year, WHO adopted another resolution calling on all 194 Member States to develop comprehensive national strategies to tackle viral hepatitis.

Viral hepatitis refers to five viruses – hepatitis A, B, C, D and E – which are very distinct but all of which cause inflammation of the liver, the meaning of the term hepatitis. Within the UK the two of primary concern are hepatitis B and C, which generally become persistent (“chronic”) illnesses, damaging the liver over many years and leading in significant numbers of people to liver cirrhosis and liver failure and/or liver cancer. Wales and Scotland have national strategies for both viruses, whereas England and Northern Ireland only have strategies for hepatitis C, which is seen as a bigger problem.

Hepatitis C is contracted through infected blood, which means that anyone who had a blood transfusion or blood products such as clotting factor before blood was screened in 1991 is at risk and should be tested. It also means injecting drug use is a very efficient way of contracting hepatitis C and sharing any equipment including water and spoons is extremely high risk. Almost half of people who inject drugs have hepatitis C. Even sharing straws or notes for snorting cocaine is a risk because of cocaine’s corrosive nature. It can also be contracted through unsafe tattooing or body piercing and there is a risk to babies born to infected mothers.

There is a great deal of excitement about hepatitis C at the moment because new drugs are just becoming available that can cure 90 per cent or more of people who take them. This makes elimination of hepatitis C in the UK a real possibility even though there is no vaccine. Unfortunately, of the 215,000 people estimated to have hepatitis C in the UK less than half have been diagnosed. The undiagnosed clearly cannot be treated. As a result we are seeing rocketing annual death rates, up 400 per cent since the mid-1990s. Although you can get a test at a GP, a sexual health clinic and in some pharmacies, it is a specific test you need to request and it is unlikely to be included in a general health screen. With awareness low, people don’t think about whether that are at risk and GPs don’t think to ask.

Former Beach Boy David Marks, who suffered from hepatitis C, and photographer Michelle Martinoli pose with others who feature in the exhibition of people who have lived with the illness, March 2005 Hepatitis B is equally undiagnosed and awareness is, if anything, even lower. The UK is considered to have very low levels of hepatitis B, one of the reasons it is one of just a handful of countries that does not give the very effective vaccine to all infants. This is misguided because, although there may be very low levels amongst people born in the UK, we have significant populations born in countries where hepatitis B is endemic, including much of Asia and Africa and parts of Latin America and Eastern Europe.  As a consequence we may have similar numbers with chronic hepatitis B as with hepatitis C but we are not sure.

Like hepatitis C, hepatitis B is a blood-borne virus and the major route of transmission is from mother to child. However, it is also sexually transmitted, although most people who contract it as an adult get rid of it themselves without treatment and are then immune. For most of those with chronic hepatitis B it will not be a problem but it is impossible to tell unless you have been diagnosed and are then being regularly monitored. If it does start causing liver damage, it can be treated. Although the treatment cannot cure it, it can almost eliminate the chances of liver cancer.

Alerting and persuading people at risk to go to their GP or sexual health clinic and get tested is therefore the only way we can prevent people dying unnecessary deaths from these viruses. This year, on World Hepatitis Day, the World Hepatitis Alliance and WHO have set up the largest mobile plasma screen in the world in the middle of Glasgow to coincide with the Commonwealth Games. It will feature a vast tweet wall and, if you tweet during the day with the hashtag #thinkhepatitis, bricks in the wall featuring negative messages about hepatitis will be converted to positive messages of support and eventually the wall will come crashing down.  Testing is being offered on-site by a group of Scottish charities including The Hepatitis C Trust, Hepatitis Scotland and Waverley Care. It is good that viral hepatitis is starting to get the attention it merits but, except in Scotland, it remains comparatively under-resourced in the UK and there is still a long way to go to find the 200,000-300,000 people unaware that they are living with a potentially fatal viral infection.

Charles Gore is Chief Executive of The Hepatitis C Trust

peoplePaper attempts to defend itself
voicesWe desperately need men to be feminists too
Life and Style
food + drink
Arts and Entertainment
British actor Idris Elba is also a DJ and rapper who played Ibiza last summer
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Life and Style
Mike Tyson has led an appalling and sad life, but are we not a country that gives second chances?
peopleFormer boxer 'watched over' crash victim until ambulance arrived
Arts and Entertainment
Geena Davis, founder and chair of the Geena Davis Institute on Gender in Media
Alan Bennett criticised the lack of fairness in British society encapsulated by the private school system
peopleBut he does like Stewart Lee
John Terry, Frank Lampard
footballChelsea captain sends signed shirt to fan whose mum had died
Arts and Entertainment
Rita Ora will replace Kylie Minogue as a judge on The Voice 2015
Life and Style
Life and Style
Alan Turing, who was convicted of gross indecency in 1952, was granted a royal pardon last year
Arts and Entertainment
Sheridan Smith as Cilla Black and Ed Stoppard as her manager Brian Epstein
tvCilla Episode 2 review: Grit under the glamour in part two of biopic series starring Sheridan Smith
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Account Executive/Sales Consultant – Permanent – Hertfordshire - £16-£20k

    £16500 - £20000 Per Annum: Clearwater People Solutions Ltd: We are currently r...

    KS2 PPA Teacher needed (Mat Cover)- Worthing!

    £100 - £125 per day: Randstad Education Crawley: KS2 PPA Teacher currently nee...

    IT Systems Manager

    £40000 - £45000 per annum + pension, healthcare,25 days: Ashdown Group: An est...

    IT Application Support Engineer - Immediate Start

    £28000 per annum: Ashdown Group: IT Software Application Support Analyst - Imm...

    Day In a Page

    Secret politics of the weekly shop

    The politics of the weekly shop

    New app reveals political leanings of food companies
    Beam me up, Scottie!

    Beam me up, Scottie!

    Celebrity Trekkies from Alex Salmond to Barack Obama
    Beware Wet Paint: The ICA's latest ambitious exhibition

    Beware Wet Paint

    The ICA's latest ambitious exhibition
    Pink Floyd have produced some of rock's greatest ever album covers

    Pink Floyd have produced some of rock's greatest ever album covers

    Can 'The Endless River' carry on the tradition?
    Sanctuary for the suicidal

    Sanctuary for the suicidal

    One mother's story of how London charity Maytree helped her son with his depression
    A roller-coaster tale from the 'voice of a generation'

    Not That Kind of Girl:

    A roller-coaster tale from 'voice of a generation' Lena Dunham
    London is not bedlam or a cradle of vice. In fact it, as much as anywhere, deserves independence

    London is not bedlam or a cradle of vice

    In fact it, as much as anywhere, deserves independence
    Vivienne Westwood 'didn’t want' relationship with Malcolm McLaren

    Vivienne Westwood 'didn’t want' relationship with McLaren

    Designer 'felt pressured' into going out with Sex Pistols manager
    Jourdan Dunn: Model mother

    Model mother

    Jordan Dunn became one of the best-paid models in the world
    Apple still coolest brand – despite U2 PR disaster

    Apple still the coolest brand

    Despite PR disaster of free U2 album
    Scottish referendum: The Yes vote was the love that dared speak its name, but it was not to be

    Despite the result, this is the end of the status quo

    Boyd Tonkin on the fall-out from the Scottish referendum
    Manolo Blahnik: The high priest of heels talks flats, Englishness, and why he loves Mary Beard

    Manolo Blahnik: Flats, Englishness, and Mary Beard

    The shoe designer who has been dubbed 'the patron saint of the stiletto'
    The Beatles biographer reveals exclusive original manuscripts of some of the best pop songs ever written

    Scrambled eggs and LSD

    Behind The Beatles' lyrics - thanks to Hunter Davis's original manuscript copies
    'Normcore' fashion: Blending in is the new standing out in latest catwalk non-trend

    'Normcore': Blending in is the new standing out

    Just when fashion was in grave danger of running out of trends, it only went and invented the non-trend. Rebecca Gonsalves investigates
    Dance’s new leading ladies fight back: How female vocalists are now writing their own hits

    New leading ladies of dance fight back

    How female vocalists are now writing their own hits