Hepatitis C Basics. Michael Bailey Director of Programming, CATIE. Mary Choy Regional Health Education Coordinator, CATIE

Transcription

1 Hepatitis C Basics Michael Bailey Director of Programming, CATIE Mary Choy Regional Health Education Coordinator, CATIE

2 CATIE Our History

3 Learning Objectives 1) To learn about the basics of hepatitis C (what is it, transmission, testing, treatment) 2) To share knowledge and information about resources related to treatment and support in your communities

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5 What is hepatitis? Is inflammation of the liver the hepatitis C virus? virus that infects liver cells

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7 The Hep C Virus Before 1989 it was called non-a non-b hepatitis A virus that attacks the liver Spread through blood-to-blood contact, especially shared drug-use equipment There is no vaccine

8 Numbers ~ 185 million people worldwide ~220,697 to 245,987 Canadians with chronic Hep C ~ 145,600 are previous or current injection drug users (IDU) At least 44% of people with the virus don t know they are infected Saskatchewan (54.4 per 100,000), 612 total reported cases in 2014, compared with Canada (29.3 per 100,000)

9 Test Your Knowledge WHAT IS THE DIFFERENCE BETWEEN HEP A, B AND C? Transmission Progression of Untreated Hepatitis Treatment Vaccine

10 Comparing Hep A, B and C Transmission Progression of Untreated Hepatitis Treatment Vaccine Hep A Hep B Hep C Fecal-oral route (from contaminated water, hands not properly washed after going to the bathroom) Infection usually clears on its own None Blood and body fluids like semen, vaginal fluid 85% of people can clear the virus without treatment Treatment is available and mainly works in controlling viral load Blood-to-blood contact 20% of all people clear the virus without treatment Treatment is available and can clear the virus for most people Available Available No vaccine

11 Liver Largest internal organ Can re-grow Filter of the body Filters & Cleanses Manufactures Regulates And more! liver

12 How can blood-to-blood contact happen? Sharing drug-use equipment Transfusions (pre-1992) Tattooing/piercing equipment Hygiene and grooming equipment Re-used or unsterilized medical equipment

13 But what about sex Sexual transmission is rare Risk can increase when blood is present or if either partner has an STI More common in people co-infected with HIV

14 6 months If 100 people are infected ~20 people ~80 people people years Untreated HCV Disease Progression Cirrhosis: 20 people Cancer: 1-4 people

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16 Diagnosis of Hepatitis C Hep C testing and diagnosis is a two stage process Two separate tests are needed to determine current active infection Hep C Antibody test Hep C PCR-RNA test

17 Hep C Testing - Diagnosis Antibody (EIA) Looks for Hep C antibodies in blood Indicates exposure (blood to blood contact) Have antibodies for life, but they don t protect against getting Hep C again Window period 6-9 weeks, but can be up to 6 months

18 Hep C Testing - Diagnosis RNA (PCR) Looks for the hepatitis C virus measures viral load and genotype Window period: 1-3 weeks shows active infection

19 Liver Damage Fibrosis = scar tissue that forms on the liver in reaction to an infection or toxin Cirrhosis = severe widespread scarring that destroys the liver

20 METAVIR Score 20

21 Monitoring Liver Damage Liver enzyme tests High enzyme levels mean some sort of liver damage is happening Liver function tests Can show if the liver is working properly

22 Monitoring Liver Damage Ultrasound Uses sound waves to take a picture of the liver Shows the difference between a healthy liver and one with a lot of damage Also screens for liver cancer Fibroscan FibroTest Biopsy

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24 What is Hep C treatment? Goal is to clear the virus from the body called SVR (sustained virological response) Direct-Acting Antivirals (DAA) Moved from boosting immune response to inhibiting the virus and viral replication

25 Treatment Options: Pan-Genotypic and Genotype 1

26 CATIE Website Treatment Information

27 Side Effects New medications have fewer side effects What can we do to manage side effects? Drink a lot of water Take your pill with food Listen to your body, rest when you can Gravol for nausea, melatonin for sleep Talk to the treatment team

28 New Hep C Treatment, cont. Best practice includes a multidisciplinary team with lots of support

29 WHAT DOES SUPPORT LOOK LIKE IN YOUR COMMUNITY? Activity 2 Small group discussion 1. Are there any support groups or programs in your community? 2. What might support look like in your community? 3. Where would people with Hep C (probably seeking treatment) access traditional medicine and support in your community?

30 Specialty Care Clinics Regina General Hospital, Regina Outpost Health Centre, Regina Positive Living Program, Saskatoon Westside Clinic, Saskatoon Royal University Hospital, Saskatoon Positive Care Program (Access Place), Prince Albert

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32 Things that can help Nutrition Balanced diet: low fat, low sugar, low salt, high fiber (fruits and veggies) Exercise A little goes a long way Support From other people who have hep C, family, friends, & community workers Reduction of activities that harm health

33 Access New HCV medications can cure nearly everyone... They should be available to everyone with HCV

34 Activity 3 Small group discussion HOW TO GET INVOLVED

35 Be involved Keep a diary Have blood work done in advance Ask questions Be involved in healthcare decisions Go to your appointments for ongoing checkups Try to be on-time and give notice when cancelling appointments

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37 Prevention Harm Reduction Needle Exchange Programs, Supervised Injections Sites Peer involved, non-judgment, practical Blood Screening Using barriers during sex (condoms) Routine practices/infection control Education/counselling/information Determinants of health

38 Injection equipment filters cooker water tourniquet syringe

39 Safer Crack Kit Glass pipe with screens mouthpieces Pipe screens Full kit

40 CATIE is now on Facebook and Twitter We tweet, inform and engage with you through our online Twitter and our Facebook Page CATIEInfo. Keep in-touch with us, find out what s new from CATIE, and stay in the loop on the newest HIV and HCV treatment and prevention information. Join in the conversation! Join us on Twitter and Facebook! 40

41 General Inquiries and Information Line Richmond St W Suite 505/Box 1104 Toronto, ON M5V 3B1

42 Contact Mary Choy Regional Health Education Coordinator CATIE Phone: ext

43 Disclaimer Decisions about particular medical treatments should always be made in consultation with a qualified medical practitioner knowledgeable about HIV- and hepatitis C-related illness and the treatments in question. Information accessed through or published or provided by CATIE is not to be considered medical advice. We do not recommend or advocate particular treatments and we urge users to consult as broad a range of sources as possible. CATIE endeavours to provide the most up-to-date and accurate information. However, information changes and users are encouraged to ensure they have the most current information. Users relying solely on this information do so entirely at their own risk. Any opinions expressed herein or in any resource accessed or published or provided by CATIE may not reflect the policies or opinions of CATIE or any partners or funders. Information on safer drug use is presented as a public health service to help people make healthier choices to reduce the spread of HIV, viral hepatitis and other infections. It is not intended to encourage or promote the use or possession of illegal drugs.