A Conversation with an Infectious Disease Specialist

Published on July 28, 2020

This World Hepatitis Day, we are shedding light on ways to prevent this inflammatory disease featuring expert advice from Dr. Curtis Cooper. Dr. Cooper is an infectious disease specialist in the Department of Medicine at The Ottawa Hospital and Director of the hospital’s Viral Hepatitis Program. He is also an Associate Professor with the University of Ottawa and a Scientist with the Ottawa Hospital Research Institute. As a respected authority within his subspecialty he was recently named President of the Canadian Foundation for Infectious Diseases. We want to thank him for his contributions to this blog.

In 2017, a total of 4,905 cases of Hepatitis B virus (HBV) infections and 11,592 cases of Hepatitis C virus (HCV) infections were reported in Canada, representing a rate of 31.7 per 100,000 population [i]

What is Hepatitis and what are its causes?

What is Hepatitis and what are its causes?

Hepatitis is inflammation of the liver tissue. There are many causes of this liver infection; the most prevalent are:

  • Excess Alcohol use
  • Fatty Liver Disease
  • Medication-induced liver disease
  • Hereditary Liver Conditions [TS1]
  • Hepatitis viruses
  • Toxic substances such as alcohol and certain drugs
  • Autoimmune and hereditary liver diseases

What are the different kinds of Hepatitis?

  • Hepatitis A (caused mostly by faecal contaminated food and water),
  • Hepatitis B (results from body fluid exposure to unvaccinated individuals),
  • Hepatitis C (contracted mainly by injection drug use),
  • Hepatitis E (most common world-wide, caused by faecal contaminated food and water)

What is the best way to build awareness of the disease?

The best way to build awareness is by providing widespread educational messages about mechanisms to protect against contracting the virus such as avoiding risky behaviours like sharing needles, having unprotected sex and drinking large amounts of alcohol.

Canadians can protect themselves by getting vaccinated against hepatitis A and B, practicing good hand hygiene and maintaining a proper diet.

Universal screenings for HCV can identify tens of thousands of undiagnosed HCV cases in Canada, enabling these individuals to receive curative HCV treatment, thereby preventing many cases of liver cancer and liver failure.

Are there vaccines for all types of Hepatitis and what is the effectiveness for each?

Vaccines are available for Hepatitis A and Hepatitis B, which are very safe and effective. Dr. Cooper advises that everyone should get vaccinated for Hepatitis A and B if not already done. There is no current HCV vaccine.

What are the harmful consequences of not treating Hepatitis?

If left untreated, HCV can lead to serious health complications such as liver damage, scarring of the liver (cirrhosis), liver cancer and even death. It can also increase the chance of infecting others.

Tell us a little about your work in the field of Hepatitis?

Our OHRI/TOH Viral Hepatitis Research Program has led to the development of improved HCV antiviral therapies. Today, patients in the Ottawa region and worldwide benefit from these safe, well-tolerated, easy to take, short duration and highly curative treatments. Over the two years we have cured well over 1000 people infected with HCV in the Ottawa-region alone. We have now turned our attention to developing more effective HBV antiviral therapies and vaccines. Trials are already underway.

Our viral hepatitis clinical team utilizes a multidisciplinary model of care. Our integrated collaborative team consists of infectious diseases and gastroenterology/hepatology specialists, nurses, social workers, psychologists and pharmacists expertise. We individualize care based on the patient’s needs and challenges to engagement and retention in care. In addition to our outpatient clinic based at the General Campus, we have a very successful Telemedicine Program and Community Liaison Program which links our expertise directly to the patient’s location within the community.

To conclude, the long-term outcomes of Hepatitis claim many lives each year and is on the rise. Targeted, strategic action plans to help educate vulnerable populations and those most susceptible to this disease will help prevent and control the complications and negative outcomes associated with Hepatitis.

[i] https://www.canada.ca/en/services/health/publications/diseases-conditions/report-hepatitis-b-c-canada-2017.html