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

Shoppers at Selfridges department store in central London

Jeremy Paxman has admitted he is a 'one-nation Tory' and complained that Newsnight is made by idealistic '13-year-olds' who foolishly think they can 'change the world'.
peopleFormer Newsnight presenter is being touted for a brand new role
Michael Buerk in the I'm A Celebrity jungle 2014
File: David Cameron offers a toast during a State Dinner in his honour March 14, 2012
voicesAnd nobody from Ukip said babies born to migrants should be classed as migrants, says Nigel Farage
Life and Style
ebookNow available in paperback
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Arts and Entertainment
Avatar grossed $2.8bn at the box office after its release in 2009
filmJames Cameron is excited
Arts and Entertainment
Stik on the crane as he completed the mural
Happy in his hat: Pharrell Williams
Arts and Entertainment
Stella Gibson is getting closer to catching her killer
tvReview: It's gripping edge-of-the-seat drama, so a curveball can be forgiven at such a late stage
Brazilian football legend Pele pictured in 2011
peopleFans had feared the worst when it was announced the Brazil legand was in a 'special care' unit
i100(More than you think)
Brendan Rodgers seems more stressed than ever before as Liverpool manager
FOOTBALLI like Rodgers as a manager but Liverpool seem to be going backwards not forwards this season
The Magna Carta
archaeologyContemporary account of historic signing discovered
Phyllis Dorothy James on stage during a reading of her book 'Death Comes to Pemberley' last year
peopleJohn Walsh pays tribute to PD James, who died today
Benjamin Stambouli celebrates his goal for Tottenham last night
Life and Style
Dishing it out: the head chef in ‘Ratatouille’
food + drinkShould UK restaurants follow suit?
peopleExclusive: Maryum and Hana Ali share their stories of the family man behind the boxing gloves
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

    Ashdown Group: Senior PHP Developer - OOP, Javascript, HTML, CSS, SQL

    £39000 per annum: Ashdown Group: Senior PHP Developer - OOP, Javascript, HTML,...

    Austen Lloyd: Commercial / Residential Property - Surrey


    Recruitment Genius: Graduate Programme - Online Location Services Business

    Negotiable: Recruitment Genius: What do you want to do with your career? Do yo...

    Recruitment Genius: Senior QC Scientist

    Negotiable: Recruitment Genius: This company is a leading expert in immunoassa...

    Day In a Page

    Homeless Veterans Christmas Appeal: ‘We give them hope. They come to us when no one else can help’

    Christmas Appeal

    Meet the charity giving homeless veterans hope – and who they turn to when no one else can help
    Should doctors and patients learn to plan humane, happier endings rather than trying to prolong life?

    Is it always right to try to prolong life?

    Most of us would prefer to die in our own beds, with our families beside us. But, as a GP, Margaret McCartney sees too many end their days in a medicalised battle
    Thomas Cook's outgoing boss Harriet Green got by on four hours sleep a night - is that what it takes for women to get to the top?

    What does it take for women to get to the top?

    Thomas Cook's outgoing boss Harriet Green got by on four hours sleep a night and told women they had to do more if they wanted to get on
    Christmas jumper craze: Inside the UK factory behind this year's multicultural must-have

    Knitting pretty: British Christmas Jumpers

    Simmy Richman visits Jack Masters, the company behind this year's multicultural must-have
    French chefs have launched a campaign to end violence in kitchens - should British restaurants follow suit?

    French chefs campaign against bullying

    A group of top chefs signed a manifesto against violence in kitchens following the sacking of a chef at a Paris restaurant for scalding his kitchen assistant with a white-hot spoon
    Radio 4 to broadcast 10-hour War and Peace on New Year's Day as Controller warns of cuts

    Just what you need on a New Year hangover...

    Radio 4 to broadcast 10-hour adaptation of War and Peace on first day of 2015
    Cuba set to stage its first US musical in 50 years

    Cuba to stage first US musical in 50 years

    Claire Allfree finds out if the new production of Rent will hit the right note in Havana
    Christmas 2014: 10 best educational toys

    Learn and play: 10 best educational toys

    Of course you want them to have fun, but even better if they can learn at the same time
    Paul Scholes column: I like Brendan Rodgers as a manager but Liverpool seem to be going backwards not forwards this season

    Paul Scholes column

    I like Brendan Rodgers as a manager but Liverpool seem to be going backwards not forwards this season
    Lewis Moody column: Stuart Lancaster has made all the right calls – now England must deliver

    Lewis Moody: Lancaster has made all the right calls – now England must deliver

    So what must the red-rose do differently? They have to take the points on offer 
    Cameron, Miliband and Clegg join forces for Homeless Veterans campaign

    Cameron, Miliband and Clegg join forces for Homeless Veterans campaign

    It's in all our interests to look after servicemen and women who fall on hard times, say party leaders
    Millionaire Sol Campbell wades into wealthy backlash against Labour's mansion tax

    Sol Campbell cries foul at Labour's mansion tax

    The former England defender joins Myleene Klass, Griff Rhys Jones and Melvyn Bragg in criticising proposals
    Nicolas Sarkozy returns: The ex-President is preparing to fight for the leadership of France's main opposition party – but will he win big enough?

    Sarkozy returns

    The ex-President is preparing to fight for the leadership of France's main opposition party – but will he win big enough?
    Is the criticism of Ed Miliband a coded form of anti-Semitism?

    Is the criticism of Miliband anti-Semitic?

    Attacks on the Labour leader have coalesced around a sense that he is different, weird, a man apart. But is the criticism more sinister?
    Ouija boards are the must-have gift this Christmas, fuelled by a schlock horror film

    Ouija boards are the must-have festive gift

    Simon Usborne explores the appeal - and mysteries - of a century-old parlour game