Tuesday, November 12, 2013 by: Darren Taylor
A new multi-year partnership has been forged between the University Health Network (UHN) and pharmaceutical company Boehringer Ingelheim which aims to improve care for hepatitis C patients in Ontario.
Hepatitis C is an infectious disease which, if left undiagnosed and untreated, can result in scarring of the liver, liver failure and potentially liver cancer.
According to data gathered by healthcare experts, hepatitis C affects at least 240,000 Canadians, with some estimates as high as 400,000.
The Canadian Liver Foundation estimates that since 2007 approximately 500 people die from hepatitis C-related illnesses in Canada annually.
According to data from 2009, approximately 10,000 to 12,000 new cases of hepatitis C are diagnosed in Canada each year.
It is also estimated that 21 per cent of Canadians (and possibly more) infected with hepatitis C remain undiagnosed.
While hepatitis C can be diagnosed, treated, managed and cured, there is a definite need for more health care professionals with the required specialized expertise to help hepatitis C patients outside large urban areas in Ontario.
With that in mind, the UHN (which includes Toronto General and Toronto Western Hospitals, Princess Margaret Cancer Centre, and Toronto Rehabilitation Institute) has received $600,000 in funding from Boehringer Ingelheim to launch a new program which takes a three-pronged approach in the battle against hepatitis C.
The program, known as Link-C, aims to inspire more healthcare professionals in rural areas to get the necessary training to treat hepatitis C, encourage people to be screened, diagnosed and educated about the symptoms and treatments for the disease, as well as developing an effective screening program for hepatitis C.
SooToday.com spoke with Registered Nurse Cathy Woldanski, Hepatitis C Treatment Nurse at the Group Health Centre (GHC).
Because the liver is a very resilient organ, Woldanski told us, patients can be infected with the virus for up to 20 or 30 years before any symptoms are manifested, making it a "silent epidemic."
Patients will complain of fatigue, aches and pains and jaundice, though these symptoms can of course be indicators of other illnesses, which makes testing for hepatitis C even more important.
People at increased risk for hepatitis C include those who received a blood transfusion in Canada before 1992, undergone surgical procedures in unsterilized conditions outside North America, those who have shared needles or other drug paraphernalia, received tattooing or piercing without professional sterilized instruments (or through using shared ink), any sexual activity that includes contact with blood, or who have shared items such as razors, manicure and pedicure equipment.
Excessive alcohol consumption will also aggravate hepatitis C.
Woldanski said there are approximately over 1800 people in Algoma with the disease, with about 50 newly-diagnosed cases every year in the region.
Nationally, the number of hepatitis cases is expected to double or triple over the next decade.
Woldanski said: "We're going to start to see more people diagnosed because hopefully, with increased awareness, more people will get tested."
"Treatment is out there and we can cure people."
Woldanski said while the new Link-C initiative is designed to help increase the number of healthcare professionals trained in hepatitis C treatment in rural areas, "in the Sault and Algoma region we're very fortunate because the Ministry of Health has granted us (at GHC) a team approach which supports patients and enhances awareness."
"We have an outreach worker, a registered social worker, two registered nurses with myself included and Dr. Bignell who is a Gastroenterologist who's been treating patients with stomach, bowel and liver disease all along."
However, Woldanski is enthusiastic about Link-C.
"We're also very fortunate to have this new connection between the University Health Network and Boehringer Ingelheim through Link-C, because larger hospitals have clinical trials and all the upcoming treatment regimes."
"We had been treating hepatitis C the same for about 13 years, then all of a sudden there has been a new medication in the last year-and-a-half, with more coming."
Despite the learning curve involved with administering the new medications, Woldanski describes this as "an exciting time" in hepatitis C treatment.
"We can connect with doctors at hospitals in larger urban centres through weekly webinars through Link-C."
"The doctors are able to educate us on an ongoing basis on the latest treatment regimes," Woldanski said, whereas before, patients would often have to be referred to specialists in London or Toronto.
Screening for the disease consists of a blood test.
If that initial blood test is positive, then a second, more specialized blood test is required.
Treatment, with medication, lasts 24 to 48 weeks.
If one medication fails to work, another medication is then tried, with the GHC health team always being vigilant of a patient's liver condition.
Anyone who wishes to be tested for hepatitis C may arrange for a blood test through his/her family doctor, while those without a family doctor may go to Algoma Public Health (APH) for testing.
Patients anywhere in the Algoma region may reach the GHC hepatitis C treatment department at 1-888-943-4372 for assistance.