KEY POINTS:
It's a disease often called the sleeping dragon because those infected may remain relatively free of clear-cut symptoms for years.
Many New Zealanders are thought to have the disease but most will be unaware of it.
It even slips under the radar of many doctors. But it can be devastating. Every at-risk New Zealander should be checked for the hepatitis C virus.
About 45,000 to 50,000 people have the hepatitis C virus (HCV), which is spread by contact with contaminated blood.
Those at highest risk include people who have injected drugs using unclean or shared equipment, and some migrant groups from countries with a high prevalence of HCV.
Also included are people who received unscreened blood, blood products or organ transplants before universal screening for HCV in blood and organ donors.
Screening was introduced in July 1992 but people who received either blood products, transfusions or organ transplants overseas after this date may still be at risk.
Almost 20 per cent of people with HCV infection will not have any of these risk factors for previous exposure to HCV.
In many of these, inadvertent transmission might have occurred through sharing a toothbrush with someone with HCV infection, especially if one or both have the common disease of gingivitis or bleeding gums. Or they could have shared a razor with someone with HCV infection, or had a tattoo or body piercing performed without sterile, disposable equipment.
HCV infection causes the liver to become inflamed and eventually stop working properly and, devastating though this is, many infected people will show no signs at all for many years.
Those who do will report tiredness, sensitivity to alcohol or just feeling unwell - not symptoms that scream a life-threatening condition.
Despite the vague signs of illness, hepatitis C can be extremely serious. The disease can wreak havoc on the liver and can eventually lead to cirrhosis or liver cancer.
In 2005, liver cancer was the world's third most common cause of cancer deaths and most of those cases were the result of infection with the hepatitis B or C virus.
Since 2000, the number of liver cancers caused by HCV has increased more than five-fold at the Auckland Hospital Liver Unit.
In the Western world, more liver transplants are carried out for complications of HCV infection than for any other cause.
However, most people with HCV will never develop liver failure or liver cancer but many will still suffer from fatigue, sore joints and muscles and the general malaise brought on by this disease.
The direct costs associated with the management of people with HCV infection are projected to exceed $400 million by 2030. The indirect costs (from reduced quality of life and reduced earning capacity) will add considerably to the impact of the HCV epidemic on our society.
But there is treatment and there is hope. A blood test will tell whether you have been exposed to the virus and, if you have been exposed, a second test will confirm if you have become infected by the virus. (Once the initial illness subsides, 60 to 80 per cent of people will continue to have chronic HCV).
Cirrhosis of the liver can be prevented by earlier detection and management of HCV infection. Antiviral therapies will cure most people with HCV infection.
These have been available and funded by Pharmac since 2004. Despite this, fewer than 10 per cent of New Zealanders with HCV infection have ever received antiviral treatment.
Studies in Australia and the United States suggest that more than 50 per cent of New Zealanders infected with HCV need to be treated to avoid the expected doubling of cases of liver cancer and liver failure by 2020.
For those who are not successful in getting rid of the virus, there are possible new treatments just over the horizon.
But, in the meantime, they need to keep themselves as healthy as possible by stopping smoking, not drinking alcohol, eating a low fat and healthy diet and getting plenty of exercise.
A healthy lifestyle will reduce the effects of the liver disease HCV eventually triggers.
The message is simple. If you think you may have been at risk for HCV, get tested. It's a simple visit to the GP and a simple blood test.
And if you have HCV, being diagnosed will, at the very least, allow you to improve your quality of life and treatment is available which may cure you.
If you think you may be at risk of having HCV virus, book a visit to the doctor or contact the Hepatitis C Support Group toll free on (0800) 224-372.
