'Silent epidemic' amongst south Asian community

Black and minority ethnic communities are instrumental in tackling public health issues in the UK, serving vital roles as doctors and nurses in hospitals across the country. However, as beneficiaries of the system, massive health inequalities exist.

None more so that in the prevalence of hepatitis amongst those who originate from south Asian countries. Known as the 'silent epidemic', hepatitis is suffered disproportionately by south Asian communities who are 5 times more likely to have the disease, compared to the wider population.

This week, the All Party Parliamentary Group (APPG) on Hepatology met to not only raise awareness of the disease, but to ensure that the government provides the necessary framework and resources to tackle the issue.

Speakers at the event included Anne Milton MP, Minister for Public Health, Virendra Sharma MP, Vice-Chair of the APPG on Hepatology and Professor Graham Foster from the Royal London Hospital and President-Elect of the British Association for the Study of the Liver.

The speakers cited stereotyping as the main reason for the low response rate to early testing. Health Minister Anne Milton said, "the biggest challenge is overcoming the reflex stigma", as the stereotypical view of hepatitis C carriers is those who are drug users or have a significant alcohol intake. In earlier years when hepatitis was being researched, many believed it to be carried by alcohol drinkers and drug users. However, now it has been discovered that the disease is passed by blood to blood contact and is not only caused by alcohol or passed by drug users. Many hospitals in developing countries have poor facilities and do not use hygienic routines with regard to needles and blood transfusions, which has also been a cause of the spread of the disease. Milton highlighted the need to move away from these stereotypes and emphasised the need for testing people earlier to combat the disease effectively.

Professor Graham Foster explained the prevalence of the disease amongst south Asian communities as a result of poor vaccinations in childhood. An estimated nine out of 10 people with hepatitis C are not aware they are living with it, particularly as people can be infected with the virus for more than 20 years before symptoms develop. This can result in individuals aged 30-40 years old becoming symptomatic, with the disease causing harm to the liver and in its chronic stage resulting in liver cancer or cirrhosis of the liver. .However, Foster made it clear that hepatitis need not be a 'timebomb virus' and early detection was key in helping individuals to survive.

Worryingly, the stereotype views of who suffers from hepatitis are not only held by members of the public, but often by health professionals too. Opal Greyson a Hepatology Nurse Specialist reinforced this point saying that many medical professionals do not see south Asians as a primary community susceptible to the disease, therefore in many cases it is not treated until the symptons are chronic.

Sultan Mahmood knows this only too well. Born in Pakistan, Mahmood moved to Bradford in 1993. It wasn't until 2001 that the symptoms began to occur and he found out that he had hepatitis C. Mahmood said, "When they told me what was wrong I turned to my wife, but we both had no idea of this condition and that I could eventually die if I did not get treatment." Unfortunately Mahmood's case is not isolated. Consultant Hepatologist Sulleman Moreea said that he "estimated that around two-thirds of people born in south Asia and living in Bradford do not know they have the condition."

The human cost of the disease is clearly devastating, and the financial implications are also extremely high. If the disease is identified early enough, treatment and cure costs between £3,000 - £4,000. However if left undetected, the costs of a liver transplant are approximately £100,000 per patient with ongoing care costs.

Vice-Chair of the All-Party Parliamentary Hepatology Group, Virendra Sharma MP, said," Raising awareness is absolutely crucial. Anyone who has had a blood transfusion, surgery, dental work, an injection or even a cut at a street barber in a high-prevalence country such as Pakistan should consider a hepatitis C test. Earlier diagnosis allows earlier treatment, and that will save lives."

For more information about screenings in your area, contact the Hepatitis C Trust

Misha Sylver and Francine Fernandes