Hep C in Canadians?

[Bronwen13]

From News 1130 on twitter this morning, "The Cdn Liver Found. wants doctors to test everyone born between 1945 and 1975, suggesting many may have Hepatitis C and not know it."  Can't wait to hear how this all came about.  *rolls eyes*

[Bronwen13]

Here's the deets about the hepatitis C . . . I was born in 71, but I won't be getting tested.

http://www.liver.ca/landing-page/Hep_C_PR2013.aspx

[kathymuggle]

Me neither, 1972, Canadian.

I read the blurb you posted…I find it kind of offensive (or assumptive/funny perhaps).

"Yep, all those free-loving, groovy adventures from the past -- even stuff you only tried once -- could have left you with more than you anticipated. Symptoms of hepatitis C can take decades to cause enough liver damage for you to feel sick.

The virus is spread through blood-to-blood contact, so that psychedelic tattoo or piercing you got years ago could have infected you with the virus..."

[Bronwen13]

Haha, I know! Because last I checked, I didn't have any psychedelic tattoo back then... Mind you, I was all of 4 years old in 1975....lol

[Chloebelle]

Wouldn't we have been checked for stuff like that during all those pregnancy blood tests? You would think something like Hep C would have been detected.

[moxytocin]

Unfortunately, Hep C is not on OB panels that midwives or MDs can order as a standard (medicaid/insurance-covered) package. Hepatitis B is, but Hep C has to be ordered specially. So most pregnant women are not routinely tested for it. Since someone in her childbearing years is unlikely to be acutely ill from it (yet), and since there is no great option for treating kids should they acquire it prenatally, it's not something deemed "worth it" by payers.

Sadly, a few decades ago it was very common to do pointless/harmful prophylactic tonsillectomies on kids. And as you might know, "routine" surgeries are often delegated to inexperienced people (like new doctors). So profuse bleeding was not uncommon, and kids often received transfusions. Blood supplies weren't tested for Hep C until June, 1992. That's how my baby boomer mom got Hep C, and didn't find out until my brother and I were in grade school. She was unlucky enough to have a very serious form, too, and might be much healthier today had she known much sooner (and watched her use of tylenol in the 80s, for example.) Now, she has really unpleasant health problems that will prevent her from being very active with her grandkids.

Most primary care doctors don't screen for it, either. Most clinicians lack the time to ask the types of detailed questions that might lead someone to remember a risk factor, like "Did you get your tonsils out as a child? Or have oral surgery? Have you ever had a piercing done by a friend, even your ears, even several decades ago?" It's a lot easier (and more cost-effective) to add the screening to blood tests someone is already getting, and soft-peddle it with the comforting thought that you could have gotten it by sharing a toothbrush or other innocuous behaviors, rather than expecting primary care doctors to sit down with a 65-year old man and ask him about possible injected drug use or high-risk sexual activity when he was a teenager. Also, the medical establishment is reluctant to admit how many unsafe transfusions were done, especially in cases like with tonsillectomies, where the procedure itself was unnecessary and harmful.

[bearandotter]

Originally Posted by moxytocin 

Unfortunately, Hep C is not on OB panels that midwives or MDs can order as a standard (medicaid/insurance-covered) package. Hepatitis B is, but Hep C has to be ordered specially. So most pregnant women are not routinely tested for it. Since someone in her childbearing years is unlikely to be acutely ill from it (yet), and since there is no great option for treating kids should they acquire it prenatally, it's not something deemed "worth it" by payers.

It is free for Canadians 

Not sure why this is a vaccine discussion. There is no vaccine for Hep C. I'd get tested if I were getting bloodwork for something else (I have had testing, since I am at high occupational risk, having worked at a innercity street clinic where a huge # of my clients had it and I had a fair number of bodily fluid exposures). 

I do agree with the blurb on the liver.ca site being offensive. Hep C could have been transferred from a surgery, dental work (very rarely), sharing a nail clipper. It is endemic in some countries (Egypt comes to mind). Some people will never know where they got it and have no identified risk factors. 

Hep C can be cured (not nice, but can be done). If I had it I would rather go through the treatment while my liver was still healthy and not wait until I was symptomatic and waiting for a liver transplant. If I had a major infectious disease I would also take precautions so as decrease the risk of spreading it to my loved ones or others I have contact with.

[kathymuggle]

This is what I found on prevalence:

http://www.phac-aspc.gc.ca/sti-its-surv-epi/hepc/surv-eng.php

"Reported cases of HCV have declined in Canada in recent years.  However, the health care burden presented by existing cases that progress to more serious sequelae continues to escalate.  In 2009, 11,357 cases of HCV were reported through the Canadian Notifiable Disease Surveillance System (CNDSS), corresponding to a rate of 33.7 per 100,000 population.  This rate has decreased since 2005 (40.5 per 100,000).  The majority of cases are over the age of 30 years and among males, but the gender gap is narrowing, which is mainly driven by increasing rates in younger females.^Footnote3

The majority of HCV cases in Canada are among people who inject drugs.  Among newly acquired HCV cases with known risk factor information, injection drug use was associated with 61% of infections.^Footnote3"

^{So…..not insanely common, more common in some grousp than others.  If I am getting blood work done for another reason and they offer a test for me I will probably go for it, otherwise, and in the absence of risk factors and symptoms….nah.  I do think BearandOtter has a point about wanting to know your status so you can take extra precautions around your loved ones.}