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Hepatitis

Hepatitis is a general term meaning inflammation of the liver. Although there are many forms of hepatitis, it is most commonly caused by the hepatitis A, B, C, D or E viruses.

Types of hepatitis

Each type of hepatitis has different symptoms and modes of transmission. Hepatitis can be self-limiting (healing on its own), or can progress to scarring of the liver. Hepatitis is acute when it lasts less than six months and chronic when it persists longer. A blood test is necessary to diagnose hepatitis. Treatments for hepatitis will depend on the type. 

If you think that you have hepatitis or may have been exposed to it, contact your local health unit or your family doctor for further information. 

In Canada and BC, the most common types of hepatitis viruses are hepatitis A, B and C. These three viruses can be passed to other people, but are spread in different ways. 

  • Hepatitis A is spread through feces (fecal-oral transmission). It has a vaccine, but no cure. It does not become chronic (the virus does not stay in the body for life) but infections can result in mild or severe illness
  • Hepatitis B is spread through blood, semen or vaginal fluid. It has a vaccine, but no cure. 
  • Hepatitis C is spread primarily through blood. It may be transmitted through sexual activity, especially with people who are co-infected with HIV or have multiple sex partners or with men who have sex with men (MSM). It has a cure but no vaccine. Treatment for it is expensive and not everyone qualifies for drug coverage. Overall cure rates are higher than 90%; these vary by genotype and previous treatment experience.

Here are some ways to help protect yourself against hepatitis: 

  • get vaccinated against hepatitis A and B
  • avoid food that might have become contaminated, especially when travelling (for more about how food gets contaminated, see Hepatitis A)
  • swim only in chlorinated pools
  • do not share food, drinks or cigarettes
 

Negotiating for care & support

Hepatitis Services has developed resources for learning and practicing the skills required to talk openly about self-care needs and to ask for support in ways that more often get people the services they want.



Living with hepatitis C often involves finding a path through a maze of agencies and negotiating with multiple service providers to get the right services.


Various resources are available: 

People living with hepatitis C (HCV) frequently report experiences of stigma in health care settings. Stigma increases the burden of the disease as it can lead to a lack of testing, treatment and primary care. 


Stigma occurs when a person is negatively judged and devalued because of their HCV status. This includes self-judgment or media portrayals of HCV and can result in discrimination towards people living with the illness hepatitis C.


Why is hepatitis C stigmatized?

Hepatitis C is stigmatized for being a contagious disease and for its association with illegal drug use. Fears about transmission are fueled by inaccurate knowledge about HCV and moral judgements about drug use.

Discrimination occurs when someone is treated differently or negatively because of their HCV status. 

Examples of discrimination include: avoidance of a person with HCV, inappropriate precautions against infection and breaches of confidentiality. 


What health-care providers can do

The health care setting is pivotal in supporting people as they cope with the physical & social consequences of HCV. Many people will only disclose their HCV status to health care providers. Yet, experiences of stigma happen often at diagnosis, leading people to avoid health care. Health care providers, aware of the stigma towards HCV, can play important roles in:

  • Preventing stigma by creating a safe & positive health environment
  • Providing support for stigmatized people to prevent declines in quality of life
  • Preventing stigma by creating a safe & positive health environment
Individuals with HCV are often anxious about the reactions of others. These tips may help to create an environment of trust and non-judgment that will encourage people to engage with health care:  

  • Use standard universal precautions with everyone & no one will feel pressured to disclose to protect others
  • Avoid the question of how people acquired HCV so people won’t fear poor treatment because of associations with drug use
  • Follow policies of confidentiality & assist people to determine who needs to know about their HCV diagnosis
  • Acknowledge the expectations of active drug users about problems in obtaining pain relief to begin a discussion about an appropriate dose for them
Establish a trusting relationship by:

  • Using non-judgmental language about substance use; avoid terms like addict & drug abuser 
  • Providing information on transmission risks, the social, psychological & physical effects of drug use as well as the effectiveness of & access to treatment  
  • Providing support for stigmatized people to prevent declines in quality of life
  • Anticipate & monitor – inform & assist people with disclosure & monitor for loss of social network support
  • Refer to community resources – discrimination towards people with HCV is against the law
  • Support self-advocacy efforts – see Negotiating for Care & Support (on this page)

Resources




SOURCE: Hepatitis ( )
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