Screen baby boomers to better protect Canadians from Hepatitis C, say Edmonton virologists

Dr. Lorne Tyrrell, a University of Alberta researcher, has been awarded the 2015 Killam Prize for Health Sciences, for his work on Hepatitis B and C. Story by Marty Klinkenberg. (PHOTO BY LARRY WONG/EDMONTON JOURNAL)

 

Alberta should look at spending $134 million on a hepatitis C screening and treatment program for the province’s baby boomers, most of whom are unaware they carry a heightened risk of infection, two leading medical scientists say.

Internationally recognized virologists Dr. Michael Houghton and Dr. Lorne Tyrrell, both based at the University of Alberta, said the costs of such an initiative may seem high, but will be far worse if thousands of undiagnosed diseases progress to the point of liver cancer or cirrhosis.

“It’s bad timing for Alberta of course with some of our issues with low oil prices,” said Tyrrell, whose work in the 1980s led to the first oral antiviral treatment for hepatitis B. “But it is an important question to address of how do we eliminate hepatitis C in Canada and how much are we going to screen to find the people potentially infected who have never been tested.”

As many as 250,000 Canadians are estimated to have hepatitis C, though many don’t know it because years or even decades can pass before symptoms of liver disease are noticed.

Baby boomers and others born between 1945 and 1975 are a particular concern, largely because of the widespread use of blood transfusions at the time that relied on unsafe blood.

Yet despite the risk, recent survey results indicate 25 per cent of Canadians in this age bracket have been tested and 80 per cent are unaware they even face a heightened threat.

Sherwood Park resident Cynthia Robson, 64, said her own experience illustrates why such numbers have to improve.

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Robson said she was surprised when she went to her doctor for a routine physical in 2001 and came out with a hepatitis C diagnosis. The infection was traced to a blood transfusion she received many years earlier after giving birth to her son.

The Canadian blood supply wasn’t screened for hepatitis C until 1992, three years after a team led by Houghton first identified the virus.

“I had no symptoms other than a little bit of fatigue,” Robson said. “It was terrifying. I was mostly concerned that I may have spread it to my children.”

After several unsuccessful treatments, Robson finally found one that worked when she was given a 12-week course of Harvoni last year. Tyrrell managed to arrange coverage for the drug, allowing Robson to avoid a $150,000 cost she couldn’t afford.

Tyrrell said he and Houghton would ultimately like to see a federally co-ordinated effort around hepatitis C rather than have individual provinces continue to attack the problem in different ways. He said Canada could learn from the approaches of other jurisdictions such as the United States, Scotland and Australia, the last of which recently announced a $1-billion investment toward the cost of drugs.

In the meantime, Tyrrell said Alberta can make a good start by screening and treating its baby boomers for an estimated $134 million. A more robust program that includes other high-risk groups would cost about $253 million.

Currently, Blue Cross and drug insurers are covering drug costs only for patients with some sign of advanced liver disease, Tyrrell said. He said he and Houghton would like to see coverage extended to those at earlier stages to help prevent the virus from being spread.

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Work led by Houghton at the U of A is closing in on the world’s first vaccine against all seven genotypes of the hepatitis C virus. Phase one clinical trials are scheduled to begin next year.

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