Hepatitis

Viral hepatitis is an infective condition caused by various viruses, some of which are transmitted sexually. These viruses have a predilection for the liver and affect liver cells resulting in liver scarring and abnormal liver function. In some cases, years of liver scarring can lead to end stage liver disease.

• Viral hepatitis A is usually spread via contaminated food prepared by someone with the disease, where hygiene has been compromised. Since this virus is spread through the gastrointestinal tract, it can also be transmitted sexually by people engaging in anal sex.
• Viral hepatitis B is fairly common in South Africa. It is spread via body fluids, including semen, blood, saliva, urine, faeces and other fluids. A vaccine can prevent hepatitis B, but this was only introduced for children in South Africa in 1998, and a lot of adults were never vaccinated and remain susceptible. Hepatitis B infection sometimes clears on its own without treatment, and if treatment is needed, a single tablet a day is often enough to prevent symptoms or complications of the infection.
• Viral hepatitis C is an uncommon disease in the heterosexual population of South Africa. It is, however, more common among men who have sex with men (MSM), and especially among people who use and inject recreational drugs. There is no vaccine to prevent infection with this virus. The virus is spread through sexual fluids and via blood. Sometimes hepatitis C resolves on its own without treatment, but in about 50% of cases, the virus is not cleared and treatment is required.  Treatment is available, and the virus can be completely cured. However, the medications needed are expensive and access is limited to the private sector or specialist tertiary state hospitals.

Anova recognises that hepatitis viruses can negatively affect the sexual health and well-being of MSM and other populations and has engaged in various programmes to address this concern.

Clinical Services

Anova provides information about viral hepatitis at all of its MSM-focused clinics. Where hepatitis is clinically suspected, we provide screening for the disease, and we can link anyone who screens positive to specialist services for ongoing management. We are also able to advise around prevention of viral hepatitis including vaccination advice.

Hepatitis Research

Anova has undertaken numerous research endeavours to understand the role of viral hepatitis among Key Populations and to improve screening and access to care.  Our first research initiative was conducted in partnership with the University of Cape Town Liver Clinic and showed that viral hepatitis C was about ten times more common in MSM attending Anova’s Cape Town clinic, compared to heterosexual people attending Groote Schuur Hospital’s outpatient services. Anova’s next project investigated the rates of viral hepatitis B and C in MSM who use drugs and found that about 1 in 4 such people screened positive. Currently, Anova is working with a range of stakeholders to investigate the burden of viral hepatitis in five provinces in South Africa among different Key Populations such as sex workers, MSM and people who inject drugs. Results of this work will be available during 2018.

Anova promotes the prevention, screening and management of viral hepatitis as a priority within its package of clinical services. Information on viral hepatitis is included in all training activities provided by the company to health care workers to raise awareness of this. Anova trains healthcare workers nationally to upskill them to address the health needs of Key Populations in a non-stigmatising and enabling fashion.