What is hepatitis C?
Hepatitis is inflammation of the liver caused by one of several viruses – hepatitis A, B, C, D or E. The hepatitis C virus is carried in the blood and can only be passed on through blood to blood contact – including sharing of needles and drug equipment during injecting drug use, non-sterile tattooing and body piercing equipment or at birth from a mother with hepatitis C.
It is estimated there are up to 50,000 New Zealanders infected with the virus, and only a quarter of these people are aware they are carrying the disease. It often progresses slowly over many years without noticeable symptoms, but common signs include fatigue, nausea and abdominal pain.
Chronic hepatitis C can lead to years of ill health and reduced quality of life. Left untreated, it can cause damage to the liver that may progress to cirrhosis and, in some cases, eventually lead to liver cancer or liver failure.
For people who are infected through injecting drug use, the risk of cirrhosis is 20 to 30 percent, and 5 to 10 percent of those will die or need a liver transplant for liver failure or liver cancer.
Liver cancer from hepatitis C is increasing rapidly in New Zealand, from one case in 1995 to 29 in 2007, and chronic hepatitis C is now the leading cause of liver transplant operations. The cost of a transplant is about 10 times the $25,000 cost of treating someone with hepatitis C.
An estimated 50 percent of all New Zealanders with chronic hepatitis C infection need to be treated, and 30 percent need to be cured to avoid the expected doubling in numbers of hepatitis C-related liver cancer and liver failure by 2030.
There is no vaccine for hepatitis C, but treatment with antiviral medication can help prevent progression to chronic liver disease.
More advanced drug treatment for the virus – called directly acting antiviral treatments (DAAs) – is expected to be available in New Zealand in 2015, although funding through Pharmac has not been confirmed. These drugs have higher cure rates and shorter treatment times than the antivirals currently used in combination – pegylated interferon and ribavirin.