“I’m optimistic about the current landscape surrounding the scale-up of HCV treatment and care in the province. If we have policies in place around improving testing uptake, and addressing some of the social and structural barriers that marginalized populations face on a daily basis, I think we can get to a HCV-free future.” –Dr. Lianping Ti

Research Breakthroughs: Hope for Hep C Patients

Promise Magazine: Fall 2017
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Researchers apply lessons learned from HIV/AIDS to combat this more common – and curable – viral disease

Hepatitis C virus (HCV) is often called a “silent killer,” and for good reason: it can go unnoticed for years— even decades—before it makes itself known. By the time symptoms emerge, serious liver damage has often already occurred. And at least 44 per cent of infected individuals in Canada don’t even know they have it.

An estimated 80,000 British Columbians are infected with this blood-borne virus, the majority of them baby boomers likely exposed through blood transfusions or unsafe medical practices. It sounds like bad news, but there is plenty to be hopeful about.

Elimination strategy for HCV, applying the Treatment as Prevention® model that was pioneered at the BC-CfE, which has helped dramatically curb the spread of HIV in the province and around the globe.

Potential for Reinfection

However, there is one big difference between treatment for HIV and the HCV cure: the potential for reinfection. “For sustained HIV, antiretroviral therapy provides life-long treatment for people, and an undetectable viral load,” explains Dr. Lianping Ti, Research Scientist, Epidemiology and Population Health, BC-CfE at St. Paul’s. “With the new DAA medications (direct-acting antiviral) for HCV treatment, you can be cured 95 per cent of the time. However, once cured, there is no immunity.”

Understanding the risks of reinfection is a critical part of any effort to curb HCV infection, which is why Ti is leading a study to examine factors that affect HCV reinfection among at-risk populations. Per-SVR (PrEseRvation of Sustained Virologic Response) is a prospective longitudinal cohort study of patients who have successfully cleared HCV, and Ti’s goal is to enroll 730 patients from the Greater Vancouver area who will be followed for the next four years.

“There’s some research out there around reinfection, but most of it has been conducted over short periods of time and is very clinical. It’s important to capture data on whether individuals have accessed or engaged in harm reduction, addiction treatment, or social services, and how these might protect against reinfection,” says Ti. “We know little about what the rates of reinfection are among different groups in the province, and we need a better understanding of how to minimize reinfection risk among marginalized populations such as people who inject drugs, people who engage in sex work, and men who have sex with men. The question really is, ‘What more can we do?’”

We know harm reduction is effective, but what else can we do to help prevent people from contracting HCV again?

Answering that question is critical to halting the spread of HCV, and to replicating the successes seen with the HIV Treatment as Prevention® model. As Ti notes: “Once we have a better sense of how much we need to scale up harm reduction and other support services in the province to prevent reinfection, then we can effectively apply that model to HCV.”

Dr. Ti’s research relies on the support of donors like you. Give now at donate.helpstpauls.com/BC-CfE

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