Monday marks World Hepatitis Day, a day established in order to increase national and international efforts on hepatitis.
In 2016, Canada had pledged to support the World Health Organization’s (WHO) campaign to eliminate the disease by 2030 – though Montreal’s Jewish General Hospital chief of infectious diseases Dr. Karl Weiss says this won’t happen unless something changes in Quebec.
“We’re not going to eliminate hepatitis B and C, I think, because the number of people who are affected by the disease are so high around the world that it would be very difficult,” said Dr. Weiss. “The majority of Canadians with either hepatitis b or hepatitis c acquired the infection outside of the country.”
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Hepatitis is an inflammation of the liver that is caused by a variety of infectious viruses and non-infectious agents leading to a range of health problems, including severe liver damage and cancer, some of which can be fatal. There are variety of different types of the disease – labeled A, B, C, D, E – with the most common ones being type A or B.
“The complication of hepatitis B and hepatitis C are pretty serious sometimes,” said Dr. Weiss. “They can lead to cirrhosis and to liver cancer, a certain type of liver cancer. And they’re both either Treatable or curable. The difference being that for hepatitis B, you rarely cure hepatitis B, but you can control the disease. And for hepatitis C, with the tools we have today, we can cure the disease.”
Dr. Weiss says carrying the disease varies case by case and that it can be picked up when visiting a different country or a high-risk area, acquiring type B and C is mostly through I.V. drug use, or by sexual contact.
In 2021, Quebec reported 805 cases of hepatitis C, representing 10.7 per cent of all reported cases in Canada.
“The data we have, it appears that most Canadian provinces and territories are still on track to eliminate hepatitis C as a public health threat by 2030,” said Jennifer Van Gennip, executive director of executive director of Action Hepatitis Canada. “However, Ontario, Quebec, and Manitoba still are not, and that accounts for a large portion of the impacted population.”
“When we are today in, let’s say, 2025, and you look at this prediction, obviously, we’re not there,” said Dr. Weiss. “So, it’s very difficult to make prediction like this. I think it’s better to have a strategy to try to promote, for example, the hepatitis B vaccine around the world and to try to lower the number of people who will become carriers.”
Dr. Weiss says immunization is needed – noting how current research shows timely elimination would save hundreds of lives and over $122 million in direct medical costs.
Van Gennip says most Canadians assume that if they should be offered a test or a vaccine, the healthcare system would provide it, but she states there are no national screening guidelines for hepatitis B. She clarifies that the hepatitis C guidelines “are outdated and not aligned with global advice.”
“Viral hepatitis is the second most deadly infectious disease worldwide, even though hepatitis C is curable and hepatitis B is vaccine-preventable and treatable, It is sometimes easily dismissed because it is stigmatized,” Van Gennip said. “Our health is interconnected, and any public health threat should concern us all. It is well within our ability to eliminate, but it takes political will, which seems to be especially lacking in Quebec.”
Both Dr. Weiss and Van Gennip recommend those affected to visit their doctor and ask to be tested for hepatitis B and C, and check if you have been vaccinated for hepatitis B.
“The risk of dying and complication is very high,” said Dr. Weiss. “So, the importance right now is more screening and taking care of these people.”
