IN THE PAST four years, over 4,000 people have been cured of hepatitis C in Ireland – but up to three times that number could be infected with the virus and not know.

Hepatitis is referred to as “a silent killer”, as the viral infection has no symptoms in many cases.

On World Hepatitis Day today, people who are thought to be most at risk of infection are urged to get checked for hepatitis – that’s those who may have had a blood transfusion before 1990, those who may have had medical treatment or a tattoo in a developing country, or those who may have transferred blood during sex.

In an interview with TheJournal.ie, Professor Aidan McCormick, clinical lead for the National Hepatitis C Treatment Programme spoke about the misconceptions about hepatitis drugs, the free treatment programme, and those who are most at risk.

What is hepatitis?

There’s different types of hepatitis, but the chronic strains are hepatitis B and C. You can get them by passing body fluids, mostly blood, from one person to another.

They can both lead to scarring of the liver, sclerosis and liver tumors, so in cases were there are symptoms, people can become jaundiced and fatigued. Although hepatitis C is curable, hepatitis B can only be suppressed by drugs.

There are symptoms, it can be silent for years until you develop advanced disease. 

Hepatitis A is less severe: you can get it orally by drinking badly-treated water and or shellfish. You will get quite sick but you get rid of it eventually.

“Generally, when someone goes to countries that don’t have good sewage systems, which is quite common in underdeveloped countries, they can get hepatitis from drinking contaminated water and eating certain foods like shellfish,” McCormick says, who has worked in the Irish National Liver Transplant Unit in St Vincent’s University Hospital for the past 24 years.

HSE HSE

“The main way hepatitis C is transmitted in western countries is through intravenous drugs, from sharing needles and sharing equipment, which is around 80% of those with hepatitis.”

But there are some people who were infected through the health systems. Those who received a blood transfusion before 1990 are also possibly at risk, as the tests needed to detect hepatitis weren’t in place until then.

The main people are those who had blood transfusion many years ago, blood transfusions in countries that are not as advanced, or who experimented with drugs once or twice, or had a tattoo where the needles weren’t cleaned… They might have got the tattoo when they had a few drinks on them a few years ago and not thought about it again since.

Hepatitis is very difficult to transmit it sexually, but it can happen if you’re having high risk sex where there is blood. It’s most common among men who are having sex with men and partaking in particular sexual practices, but more generally, it’s very rare.

If you fall into one of those categories, you should get checked for hepatitis – it won’t show up in a general blood check, so you’ll have to ask specifically for it.

How is it treated or cured?

“The treatment for hepatitis C used to be very difficult,” McCormick says. ”There’s a perception that the treatment for hepatitis C is very bad – that’s gone now.”

“We used to have to give injections every 6 – 12 months, and it was a very difficult treatment with lots of side effects. Only 40% of people were cured.”

Now, since 2015, we just have to give tablets once a day for 8-12 weeks and 90% of people are cured. 

With this treatment, the side effects are the same as they were with the dummy tablets, he adds. The only problem these new drugs cause is that when they interact with other drugs, especially street drugs, it can cause problems.

Currently, the treatment to cure hepatitis C is free. Although the drugs used to treat it cost €50,000 for the 8-12 week course, the HSE has negotiated a deal along with other countries so that the treatment is widely available to people.

Patients are getting a fantastic deal – we’re now trying to take the treatment out of hospital and into the community.

In the past week or two they’ve begun a pilot programme to try to reach the estimated 15,000 people who are thought to be infected with hepatitis, but not yet know about it.

“We’re getting GPs to prescribe the medication in their communities, and getting it into the drug treatment centres,” McCormick says. “We’re trying to get as many people as possible.”

So you can go to your GP and get checked and then you’re referred. 

“We’re going to get our structures up and running, and so once the pilot is effective and the structures are working, we’ll roll it out to other GPs on a phased basis.”