Hepatitis C is a virus that infects the liver. It spreads through blood, most commonly through shared injection, smoking or snorting equipment, as well as reused tattoo or piercing equipment. In Canada, people who received blood transfusions before 1992 may also have been exposed.
What catches people off guard is how quiet the virus can be. Most people living with hepatitis C feel fine. There may be no pain, no jaundice — the yellowing of the skin or eyes — and no obvious sign that anything is wrong, sometimes for decades. During that time, the virus can slowly scar the liver and cause inflammation elsewhere in the body.
Without a blood test, hepatitis C can go undiagnosed for years, sometimes until liver damage has become serious. Finding out typically involves two tests: the first looks for antibodies, which show whether you have ever been infected with hepatitis C. If that test is positive, a second test looks for the virus itself to determine whether the infection is still active.
Crunching the numbers
Hepatitis C is more common than many people realize, but B.C. has made significant progress in treating it. According to the BC Centre for Disease Control, more than 26,000 people living in B.C. had tested positive for an active hepatitis C infection by the end of 2024. Of those, more than 80 per cent had started treatment, and more than 90 per cent of those treated had been cured.
That’s a big change from a decade ago. In 2015, just over 40 per cent of people with a confirmed infection had been treated. That’s half the number who are being treated today.
But those numbers only include people who have been diagnosed. People who have never been tested don’t show up in the data at all — which is a big part of why we set up a table outside VANDU on World Hepatitis Day.
Hepatitis C is curable, and treatment today looks very different than it did a decade ago. Some people clear the virus on their own, but most need treatment. That usually means taking a pill for up to 12 weeks, with few side effects. More than 95 per cent of people who complete treatment are cured.
For most people in B.C., treatment is covered by public or private insurance, with support programs available to help with remaining costs. Being cured prevents further liver damage and reduces the risk of serious complications, including liver cancer and liver failure. Many people also report feeling better after treatment, with more energy, better sleep and less pain.
There is still no vaccine for hepatitis C, and being cured doesn’t prevent someone from getting it again. That’s why regular testing remains important for people who may be exposed. The only way to know is to get tested.
World Hepatitis Day: At the table
People stopped to talk. Many were happy to share what they already knew, and what they had been through. Some told the peers they had already been treated and cured. Others went inside for point-of-care testing with the VIDC team.
Out of the 25 people who were tested, one-quarter tested positive. They were offered follow-up support that same day and connected with the clinic. For people without a family doctor, the team helped them find one — so that a positive result on a Tuesday afternoon in July could actually lead to treatment, rather than becoming a piece of paper tucked into a pocket and lost or forgotten about.
Of course, a test on its own doesn’t cure anyone. What matters is whether someone walks away with a name, a phone number and a reason to trust that the next appointment won’t be another wall.
Why peers make the difference
None of this works without people who already know the neighbourhood. CREW members are the reason the event happened at VANDU, rather than in a room people might not feel comfortable walking into. They knew where to put up posters, and it worked. More than one person that afternoon said a poster was what brought them by.
“Seeing a familiar face in a familiar place helped create an atmosphere of trust among neighbours who share community space and resources,” said Nicolas Crier of the DTES CREW. “This was helpful in getting people comfortable with testing on the spot.”
For CREW member Julie Chapman, sharing her own experience with hepatitis C is part of building that trust.
“Sharing my personal experience of when I learned I was Hepatitis C positive helps people feel more comfortable and open up more,” Chapman said. “I had it for 20 years and had no idea. A random screening at my doctor’s office found it, and I got treatment right away. Eight weeks later I was cleared of the virus. I try to encourage people to get tested.”
Grateful for program
All the peers are grateful to both VANDU for opening its space for this event, and to Vancouver Infectious Diseases Centre, which contributed its team, tests and time to make sure that everyone who received a positive result left with a next step.
If you want to know more about hepatitis C, or you are thinking about getting tested, BC Hepatitis clinics can help you find a place near you. Visit the BCCDC here.Â
This story was written in collaboration with Nicolas Crier, Samona Marsh, and Jim McLeod of DTES CREW; and Dahn Jeong and Sara Qureshi of the OPTIMISE project team at UBC and BC Centre for Disease Control.
Julie Chapman and Nicolas Crier are writers with The Shift peer newsroom at Megaphone.
Amy Romer, Local Journalism Initiative Reporter works as a mentor for Megaphone's The Shift in Vancouver's Downtown Eastside. The Shift is made up of a diverse group of individuals with lived experience of poverty, who are reporting from the DTES instead of being reported on.
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Julie Chapman with Amy Romer, Local Journalism Initiative Reporter, Megaphone Magazine.