It was following a routine annual physical that Marsha Lecour's doctor noticed an abnormality in her blood test. Marsha was sent to a liver specialist, setting off a chain of events that confirmed she had the hepatitis C virus (HCV).
"This was during the mid-1980s, where there was no marker for hepatitis C yet, so my doctor was just able to confirm it was Non-A and Non-B hepatitis, and then explained that I'd probably eventually need a liver transplant," recalls Marsha.
"At that point, I decided that I was going to become proactive about my disease. I was going to become my own advocate."
And that she did. For the next 30 years, to maintain utmost liver function, Marsha committed to healthy eating, exercise, avoidance of alcohol and any foods that contain inflammatory nutrients, among many others.
Then, in 2013, under the care of Dr. Jordan Feld, hepatologist and research director, Francis Family Liver Clinic at Toronto General Hospital, UHN, Marsha began a 48-week treatment that cured her Hepatitis C.
In true advocate form, Marsha turned her 50-year experience with HCV into a book which details life with the disease, and after the cure.
When Hepatitis C goes undiagnosed
Dr. Feld says to better diagnose and treat HCV, there must be more awareness of liver disease among family doctors and the general population.
"Most people who have the infection have no or very few symptoms even if they've been infected for decades," explains Dr. Feld.
"Because of this, hepatitis C can go undetected for a long time, until it's too late," explains Dr. Feld. He adds that "about half or more of people with Hepatitis C don't know they have it, that's why people have to ask to get screened."
This was the case for Marsha. Diagnosed in the mid-1980s, the only risk factor she could identify that may have transmitted HCV was a hospital blood transfusion in the mid-1950s.
"She was living with Hepatitis C for 30 years and felt perfectly fine," adds Dr. Feld.
Advanced liver disease usually develops when someone has been living with HCV for a minimum of 20 years, undiagnosed. By the time liver disease is advanced, patients potentially face liver failure or liver cancer.
Facts about hepatitis C and liver disease:
- An estimated 252,000 people in Canada are infected with chronic hepatitis C virus. It is the greatest burden of disease, measured in years of life lost, than any other infectious disease in Canada
- It is the only virus-caused chronic disease that we know how to cure
- About 75 per cent of affected people are Baby Boomers; About half of this group don't know they have it
- HCV is called a "silent" disease because no symptoms appear until the liver has been severely damaged
- HCV is the leading indication for liver transplantation and the leading cause for liver cancer
- Approximately 170 million people are infected with chronic HCV worldwide
- Hepatitis C is transmitted through blood to blood contact. Most common transmissions are through injection drug use, unsterilized medical equipment, and blood transfusions before 1992
So how do we prevent this? Dr. Feld says everyone – especially Baby Boomers, those born between the mid-1940s and the mid-1960s – should ask their doctors to get screened, regardless of whether or not they have any known risk factors.
HCV is mostly transmitted through blood to blood contact. This means the most common risk factors are injection drug use, treatments with unsterilized medical equipment in developing countries where hepatitis C is high, or receiving blood transfusions in Canada before 1992, when a marker for HCV was developed.
"Tell your doctor to screen you for hepatitis C or liver disease in general. It's a simple and easy test," urges Dr. Feld.
The Book of Hepatitis C
In 2014, the year that Marsha was cured, she decided to write her book entitled The Book of Hepatitis C: 7 Simple Strategies to Shift from Surviving to Thriving after Hepatitis C.
"I told Dr. Feld I wanted to do something for the community. It's really a how-to manual on how to get your life back after treatment. It's also about sound general health through nutrition, exercise, a positive mindset, self-care and how all of those pieces fit together," explains Marsha.
"It's been great to have someone speak out about the cure for hepatitis C, after the fact," says Dr. Feld.
"She lived with the infection for over 40 years; she went through a rough road and is now on the other end of it, living the benefit of the cure."
The treatment
This drug combination of ribavirin, interferon and telprevir that cured Marsha had an overall 40 per cent efficacy and presented symptoms including major depression, weight loss, hair loss and anaemia; all of which Marsha experienced.
Dr. Feld
pioneered a new 12-week treatment of HCV in 2015 that offers an efficacy of 95 per cent, and has significantly less symptoms. This drug combination is of sofosbuvir and valpatasvir.
This drug combination was developed through an international clinical trial led by Dr. Feld which changed the standard of care in treating patients with hepatitis C. The regimen has been shown to work on all forms of the hepatitis C virus, eliminating the need to first test the genetic makeup of the virus, which often delayed treatment.
