MANY people may be living with hepatitis C without knowing it. Health reporter Priya Mistry speaks to a specialist nurse who explains there are faster ways to be diagnosed and treated at Queen Alexandra Hospital
It is a virus that can appear to cause no damage to the body because of the healing powers of the liver.
But contracting the hepatitis virus can cause serious long-term problems if it is left untreated.
Today is World Hepatitis Day and the hepatology team at Queen Alexandra Hospital is urging people to come forward and see if they may be carrying the most common form of the virus – hepatitis C. In south east Hampshire, around 2,000 people have hepatitis C – without even knowing.
The Cosham hospital has up to 100 cases of chronic hepatitis C each year.
But now people can have a free mouth swab test, which can tell you within half an hour if you have signs of the virus.
Karen Gamble is a hepatology clinical nurse specialist and works with two other nurses to deliver screening services.
She says: ‘There’s still a huge amount of the population that may not know they have the virus.
‘Symptoms are hard to spot and often can only present when the liver is in trouble.’
Hepatitis C is usually contracted through blood contact and can remain undetected in the body for around 30 years before causing major liver damage.
People who have used intravenous drugs can be at risk from having the virus.
And anyone who had a blood transfusion before 1991 – when screening for hepatitis C wasn’t performed – should also get checked, as well as people with tattoos when needles may not have been sterilised.
People from sub-Sahara Africa and parts of Asia like Pakistan and Bangladesh can also be at risk.
The common symptoms are feeling tired, but for many years you won’t know you have it and silently it’s damaging your liver, leading to cirrhosis or cancer, and complications such as jaundice, internal bleeding or a build up of fluid in the stomach.
This is because the liver is able to heal and repair itself, but eventually the virus will overpower and present aggressively.
Of those that have the virus, up to 25 per cent of people will be able to clear it themselves.
But for the other 75 per cent, people could have it for decades without knowing.
Karen says: ‘If people are put off with having a blood test, then a mouth swab is a quick and easy way to see if you have the virus.
‘We have drop-in clinics in Portsmouth, Gosport, Fareham and Leigh Park.
‘We ask people do not eat, smoke or drink 20 minutes before the mouth swab.
‘The test itself involves placing a swab in your mouth and sweeping across the gumline at the top and bottom of your mouth.
‘We then leave it in a solution for 20 minutes, after which it will tell us if you have the virus or not.’
The £12 test means people will be able to find out instantly if they have the virus. If the test is positive, a blood test is arranged and a treatment plan is discussed.
‘The advantage of this is it’s quick, easy and pain-free,’ adds Karen. ‘We want to remind people or let them know about this service.
‘People can get an instant result and it quickens the whole process should treatment is needed.
‘The liver is clever and can regenerate and will compensate for an area that isn’t working.
‘If you wait for symptoms then it’s too late for us to slow down liver damage.
‘We can start reversing the damage.’
As previously reported in The News, for the past 18 months, a range of drugs have been used in clinical trials at QA with a success rate of curing the condition of 95 per cent.
In total, 20 patients who have the condition have been on the trial and a further 40 are due to start in the next few weeks.
Karen says: ‘We want to encourage people to come forward and get checked, as often people don’t think they have it.
‘But also, some don’t want to get tested because they have heard about the side effects of treatment and could be put off from it.
‘Newer treatments tested at the hospital are extremely beneficial for patients.
‘The clearance rates we are seeing across the trials are about 95 per cent.
‘At the moment these drugs aren’t approved by the National Institute for Health and Care Excellence, but by getting checked and taking part in a trial, patients can access this treatment quicker.’
Patient Ron Butterfield, of Jacobs Close in Clanfield, is backing the new test.
The 65-year-old was diagnosed with hepatitis C in September 2012.
It is not known how the retired kitchen worker got the virus, but it could be linked to DIY tattoos Mr Butterfield has.
He says: ‘I found out about the virus by mistake. When I was younger I used to drink 18 pints a night and not feel anything.
‘I have high blood pressure and am on tablets so was having a blood test for that.’
The test led to a diagnosis of hepatitis C and Mr Butterfield was put on to a 48-week treatment plan comprising of injections and tablets.
But the new drugs being trialed can reduce treatments to 12 to 24 weeks and consist of having tablets only.
Mr Butterfield says: ‘The first few weeks of the treatment were hell. ‘I felt tired and sick all the time.
‘But of course it’s all worth it as there’s a high chance that you can clear it.
‘I’d urge people to have a swab test and get treated, especially with the ongoing trials at the hospital.’
The clinics take place at the following places from 9.30am to 2pm:
- The Recovery Centre, St Mary’s Community Health Campus, Milton Road, Portsmouth, every Thursday.
- Orion Centre, Dunsbury Way, Leigh Park, every Wednesday.
- Avalon Centre, Fareham Health Centre, Civic Way, every fourth Friday.
Hepatitis A is a short-term infection that is not often found in the UK.
It is usually passed on by consuming food or water that has been in contact with faecal matter.
The virus is more commonly associated with sub-Saharan and north Africa, the Indian subcontinent (particularly Bangladesh, India, Nepal and Pakistan), some parts of the Far East (excluding Japan), the Middle East and South and Central America.
Vaccination for hepatitis A is normally only recommended if you are travelling to these parts of the world, or you are at a high risk of infection.
GP gives test
The most common route of infection of hepatitis B is at birth, from mother to child.
Around 90 per cent of infected infants will develop a chronic, often life-long infection that predisposes them to liver cirrhosis and liver cancer.
If adults are infected through unprotected sex or blood-to-blood transmission, most will clear the infection spontaneously and only 10 per cent will become chronic.
Queen Alexandra Hospital in Portsmouth sees around 60 to 70 referrals a year, and all pregnant women are screened.
There are effective antiviral drugs available that doctors use to help control it.
In some parts of the world, hepatitis B affects a large proportion of the population, such as in China and sub-Saharan Africa, where it affects eight to 10 per cent of people.
Therefore most of Portsmouth’s cases are in ethnic groups from these areas.
They are encouraged to see their GP and ask to be tested.
Historically, hepatitis E is under-recognised but is the most common cause of an acute viral hepatitis in middle-aged people, including those in the Portsmouth area.
Usually the body can fight it in about four weeks, so only the most severe cases will present at hospital.
Similar to hepatitis A, hepatitis E is caused from consuming food or water that has been contaminated from faecal matter.
The difference is the virus can be found in animals such as pigs, wild boar, deer, rabbits and rats, and although it does not cause the animals any illness, it can be passed on to humans.
One way this can happen is by eating raw or undercooked meat.