How the CLF and CASL are Strengthening the Case for Age-Based Hepatitis C Testing in Canada.

Since 2012, the Canadian Liver Foundation (CLF) has advocated for risk-based and age-based testing of hepatitis C to be adopted in Canada. Our position is that in addition to testing based on risk factors, all Canadians born between 1945 to 1975 should take a one-time test for hepatitis C, as research has shown that this age group has the highest prevalence of the chronic hepatitis C infection. Additionally, it is estimated that up to 70% of this group have not been tested, and only seven per cent is even aware of their increased risk.

Today, we feel a giant leap has been made towards Canada’s national strategy to eliminate hepatitis C in Canada by 2030.

The Canadian Association for the Study of the Liver (CASL), a longstanding partner of the CLF, consisting of experts in liver health and research, published new guidelines in the Canadian Medical Association Journal (CMAJ) on the management of chronic hepatitis C. In it, CASL joins the CLF in strongly recommending improving screening in Canada by adding a one-time test for all Canadians born between 1945 and 1975. Authors refer to hepatitis C as a ‘highly burdensome public health problem in Canada, which actually causes more years of life lost than any other infectious disease in the country.’

Hepatitis C is an infectious blood-borne disease caused by a virus that progressively attacks the liver over decades. There may be anywhere from 250,000 to 400,000 Canadians living with chronic hepatitis C, with 44 to 70 per cent of those remaining undiagnosed. Hepatitis C can manifest itself in the body for 20 to 40 years, often not showing any symptoms until the liver is severely damaged.

“It’s common for people to visit the doctor when they’re not feeling well, but sadly many infected with hepatitis C often don’t experience any symptoms or visible warning signs, especially in the early stages of the virus,” says Dr. Morris Sherman, Chairman of the Canadian Liver Foundation and Toronto-based hepatologist.

Ultimately, hepatitis C can lead to scarring (cirrhosis), liver cancer and the need for a liver transplant. In fact, chronic hepatitis C is the leading cause of liver transplants in Canada.

As a standalone method, risk-based testing (screening those based on identified risks) has not been effective in identifying all Canadian’s living with hepatitis C. Age-based testing (in addition to risk-based) can increase the probability of identifying those living with hepatitis C who don’t know when or how they might have been exposed to the virus.

“In many cases, patients are able to be cured of this deadly virus especially if detected early on, and so we’re urging people born between 1945 and 1975 to get tested instead of waiting until they feel sick,” says Dr. Sherman.

When looking specifically at the age group of people in Canada born 1945 to 1975, hepatitis C is mainly a result of medical or hospital procedures with improperly sterilized equipment, but other risk factors include using injection drugs (even once), getting tattoos, piercings, pedicures, manicures with contaminated equipment, sharing personal hygiene items with an infected person (e.g. razors, toothbrushes, nail clippers) or having had a blood transfusion or received blood products prior to July 1990. Some other factors include coming from areas of the world where hepatitis C is more common, including Asia, Africa and some parts of Europe.

By now, you may be wondering what someone living with hepatitis C can do about their diagnosis. Treatments are now available for hepatitis C that can cure almost everybody in 8 to 12 weeks, with minimal side effects. While drugs are relatively expensive, they are now covered by almost all private and most provincial/territorial drug plans.

The CLF would like to remind all Canadians born between 1945 to 1975 to ask their doctor about taking the one-time test for hepatitis C. For more information about hepatitis C, visit our hepatitis c information page or check out our latest public awareness campaign where you can also complete our online viral hepatitis risk questionnaire, which allows you to print your results and take it to your next doctor’s appointment.

Should you have questions regarding a hepatitis C diagnosis, want more information about the disease or are interested in further resources, please contact our National Help Line at 1 (800) 563-5483 Monday to Friday from 9 AM to 5 PM EST.