Hepatitis is not something one usually associates with celebration; but this year, for those who have hepatitis, there is much to celebrate: In the US, the battle to make HCV testing available at little or no cost has been won and testing is starting to be initiated. And with the Affordable Care Act (ACA) coming into effect, more and more people will be able to afford and have access to medical care and treatment.
And as for treatment! Wow. Many more people are getting cured—in fact HCV can now be cured in up to 80% of people who take the medications. Vaccines are available to prevent hepatitis B and the Chinese have developed a vaccine against HEV. For those who have chronic hepatitis B there are medications that can successfully manage hepatitis B and prevent disease progression, liver cancer, and death. Clinical trials are rolling out—better, easier and shorter treatment durations for HCV—almost daily. Many of the new HCV drugs are on the fast track or have been awarded breakthrough status to accelerate approval times! Drugs in development to treat and someday cure HBV are being investigated. This is a really exciting time!
But, and there always is a but. Things are looking up if you live in North America or the EU or other “first world” countries. If you don’t, having hepatitis is not so good. In fact, it is estimated that 170,000,000 to 180,000,000 people worldwide are infected with HCV and 350,000,000 to 400,000,000 people worldwide are infected with chronic HBV.
A quick scan of the latest posts on our blogs shows that mortality rates across the world for HCV, HBV and HEV have actually risen, due to widespread poverty and lack of universal precautions. There continue to be major outbreaks due to ignorance and greed.
As well, even in so called “First World” counties, transmission/infection rates are very high among prisoners, people who inject drugs (PWID) and people on the fringes (the poor, the mentally ill, those suffering traumatic life experiences), and many governments still refuse to implement harm reduction strategies (needle exchange, addiction services) for these at-risk populations.
There have been many expert articles on the positive effects of harm reduction, needle-exchange and safe injection sites; but the powers that be are too caught up in politics, misplaced moral directives and the failed war on drugs.
Yet, there is progress being made: slowly and surely. Years ago, who would have thought that HCV could be cured and that the potential for curing everyone with HCV is so near. Testing is now recommended for all those people who were born between 1945 to 1965 as well as for at-risk populations, and more and more people are being tested and provided with vaccines against HAV and HBV.
People and governments are listening… but they are just beginning to. Now is the time to step up and advocate for testing populations at risk and for equal access to medical care and treatment for all—rich or poor, prisoner or PWID. For effective harm reduction, eradication of viral hepatitis and support strategies for all.
It may really have gotten better; but it’s still a matter of life and death.
(World Hepatitis Day is July 28)
(World Hepatitis Day is July 28)
CD Mazoff, PhD
Hepatitis C Support Project; HCV Advocate; HBV Advocate
Hepatitis C Support Project; HCV Advocate: HBV Advocate