Days are numbered for hepatitis C

Tyler Caissie is living proof that Prince Edward Island is nearing a landmark moment in its health care history.
Caissie is one of more than 100 Islanders who no longer have the life-threatening liver disease hepatitis C. It happened after Prince Edward Island in 2015 became Canada’s first province to offer management and treatment for the most common (genotype 1) of the disease’s six viral genotypes.
Now, with even more treatment and resources, the province is nearing its goal of banishing the disease from its shores by 2025 – ahead of the World Health Organization’s 2030 target.
“I can’t imagine how much more suffering Ty would have endured had we not had access to the hepatitis C treatment,” said Linda Gallant, Tyler Caissie’s legal guardian and sister-in-law, explaining that he acquired hepatitis C from a blood transfusion decades ago. It took just five months after treatment began for him to be cured.
“When I look at Ty,” she said, “my heart is lighter just knowing this is one less thing for him to endure. It has been incredible how the program has improved his quality of life.”
There are about 550 Islanders and 250,000 Canadians with the hepatitis C virus (HCV), which is acquired through contact with infected blood. Fatigue, jaundice, and abdominal and joint pain are some of the symptoms. It can also cause liver damage (cirrhosis) or even liver cancer if left untreated.
There is no vaccine to prevent hepatitis C, and once infected, it can mean a stressful, lifelong struggle.
Then in 2015, Health PEI began offering drug treatment for Islanders with genotype 1 of the disease, which is carried by approximately 65 to 70 percent of those diagnosed. In the three years since, more than 150 Islanders diagnosed with hepatitis C genotype 1 have been treated and are now testing negative for the virus.
“Advancements in treatment therapies are highly effective, with cure rates over 95 percent,” said Island family physician Dr. George Carruthers. “Investments in drug programs – like the one we have here on PEI for hepatitis C – have provided us with access to affordable lifesaving and life-changing treatments for our patients. As a physician, there is nothing more rewarding.”
More improvements came in the provincial government’s balanced 2018-19 operating budget this past spring. It included $2 million to expand the Hepatitis C Drug Program and hire dedicated resources. These resources include a new hepatitis C coordinator and registered nurse.
Medications were recently added to the Hepatitis C Drug Program that can treat every hepatitis C genotype – affording everyone with the disease a chance to be cured. So far, 28 Islanders have since started treatment with the new medication.
“All Islanders diagnosed with hepatitis C have greater access to affordable life-saving and life-changing treatment – regardless of the genotype of disease – to achieve a cure and improve their quality of life,” Health and Wellness Minister Robert Mitchell said.
Also, an advisory committee of clinical experts will guide, inform, and support ongoing development and implementation of the provincial treatment and elimination strategy.
The province’s progressive approach is being well received nationally.
"Prince Edward Island continues to be a provincial leader in Canada, ensuring that its residents are diagnosed and linked to hepatitis C care and treatment," says Action Hepatitis Canada’s co-chair Gerard Yetman. "To see a province committing to elimination, and dedicating resources to developing a coordinated plan, is something we would like to see other provinces follow in the near future."
“Prince Edward Island has been progressive in developing and investing in a provincial HCV treatment program that is now transitioning to an elimination strategy,” echoed Dr. Lisa Barrett, clinician scientist with the division of infectious diseases at the QE II Health Sciences Centre. "The province is definitely regarded as a leader in innovative coordinated approaches to HCV care in Canada.”