OHSUTPCanada needs viral hepatitis action plan
Kevork M. Peltekian, MD
Dalhousie University, Departments of Medicine and Surgery and Hepatology Services
Geri Hirsch, RN-NP MSN,
Carla Burgess, RN-NP MN
Miller and colleagues and the Cedar Project Partnership should be congratulated for helping us understand the “how” and the “why” of the high initiation rate for injection drug use among a vulnerable population.1 But what are we doing about it?
Every year about 5000 Canadians, mostly youth, become infected with hepatitis C virus — often during the first year following initiation of injection drug use.2 Rates of hepatitis B virus, hepatitis C virus and HIV infection are much higher among street youth than among their nonstreet peers.3 In Canada, prevalence of hepatitis C virus among injection drug users is between 46% and 60%4 — in other words, at least one in two is infected.
The study also found 58.2% of urban Aboriginal youth who used injection drugs were infected with hepatitis C virus,1 compared with 12% infected with HIV. In our opinion, the high hepatitis C virus prevalence rate among our youth is an indicator for failure of our public health and education systems. So where is the action plan to prevent transmission of hepatitis C virus?
As care providers, we see youth-at-risk lacking appreciation for high prevalence of hepatitis C virus among injection drug users. Students’ knowledge about the virus is extremely poor.5,6 A recent needs assessment7 confirmed high-risk youth have limited-to-moderate knowledge about hepatitis C virus. Almost 40% said they knew “next to nothing” about it. Young people identified their school as the main place for receiving information about hepatitis C virus and other infections.
Canadians deserve an action plan to prevent hepatitis C virus infection. Appropriate, well-aimed education and peer outreach programs are desperately needed if the transmission of the virus among young users of injection drugs is to be kept to a minimum.
