Manitoba has highest hepatitis C rate in nation

WINNIPEG — Manitoba has the highest rate of hepatitis C virus in the country and it’s why World Hepatitis Day is an important day for education, an infectious disease and liver expert says.

Dr. Kelly Kaita, who heads the viral hepatitis unit at the Health Sciences Centre, said the province’s hep C virus rate of 42.3 cases per 100,000 means 589 Manitobans are diagnosed with the disease every year.

But Kaita, who wants to use World Hepatitis Day, which is today, to help educate people on how to reduce the spread of the infection, said he thinks the numbers are even worse.

“I believe 589 in Manitoba would be low,” he said. “And with hepatitis C in 0.8 per cent of the population in Canada, that would be 8,000 Manitobans with the disease.”

Hepatitis C infects the liver and, if not treated, it can cause both cirrhosis and liver cancer.

It is spread by blood contact, usually through shared needles during drug use or while getting a tattoo outside of a salon.

Six years ago, Kaita was hopeful Manitoba’s move to cover the cost of a new drug, Maviret, for eligible pharmacare patients would help the province meet the World Health Organization’s target of ending viral hepatitis as a public health concern by 2030.

With only five years to go, Kaita isn’t so sure, not just for Manitoba, but for people across the globe.

“Things are not going well worldwide,” he said. “I don’t think anyone is set to meet the 2030 WHO guidelines. It all comes down to awareness. People have to recognize who is at risk.”

Inmates are one of the at-risk groups. Kaita said that’s why staff at federal correctional facilities immediately arrange for medical treatment once it is learned an inmate has been infected with hep C.

Kaita said because provincial jail sentences are much shorter than two-year-plus federal sentences — sometimes just weeks — many inmates are discharged before their treatment starts.

“Then we don’t know where they are,” he said. “They are lost to the system.”

Other marginalized communities that are affected include Indigenous people, new Canadians, people born between 1945 and 1975, and people who inject recreational drugs.

Lucy You, vice-president of Liver Canada, said there are several reasons hepatitis C is still not being reduced to the WHO goal.

“The issue isn’t the treatment,” You said. “It’s systemic barriers to access, particularly for marginal communities.”

“Provinces like Manitoba, Ontario and Quebec are falling behind, with new modelling suggesting Manitoba may not reach hepatitis C elimination until 2050 without urgent action.”

» Winnipeg Free Press

You said there are things the federal government can do to help reduce virus rates.

“We need federal leadership to modernize screening for both hepatitis B and C, prioritize universal birth-dose HBV vaccination, invest in accurate and disaggregated data, and provide long-term funding to community organizations that are best positioned to reach and support those most affected.”

Kaita said many people are unaware of the advances in treatment, which has become easier and has fewer side-effects.

He said new drugs, taken orally, cure a person in only eight weeks, compared with the old treatment, which took six months to a year and included side-effects that patients reported were worse than getting chemotherapy.

“It is closer to 99 per cent of people being treated are cured,” Kaita said.

“We want to educate the public that there is treatment and it can lead to a reduction in liver cancer.”

» Winnipeg Free Press