Finding the starting point toward hepatitis c elimination: identifying known prevalent hepatitis c cases in southern New Brunswick, Canada

Author: Materniak S, Webster D, Higdon P, Thompson-Bourque P

Theme: Epidemiology & Public Health Research Year: 2019

The World Health Organization (WHO) defines 10 core indicators needed to evaluate health sector
response toward the goal of viral hepatitis elimination by the year 2030. The first indicator is knowledge
of actual hepatitis C (HCV) prevalence; however, current prevalence measures available for many
regions rely on mathematical modelling to obtain estimates and know little about the characteristics of
prevalent cases.
As part of regional HCV elimination efforts, a variety of methods were used to obtain data on HCV cases
in southern New Brunswick (pop. 170,537). This review of cases formed the basis for calculating regional
HCV prevalence. Through Public Health data, a list of all incident cases since 1995 was obtained. The
regional laboratory provided a list of all HCV antibody-positive results referred for confirmatory testing
since 2007. The medical records of all HCV-positive cases held by the three local major HCV treating
physicians were reviewed. Lists were cross-referenced and duplicate cases removed. Each record was
reviewed to identify the case’s current HCV infection status.
Preliminary results, as of January 2019, identified 1337 unique HCV antibody-positive cases. The average
age at diagnosis was 38.6 years, 35.6% were female, and 19.3% had not been genotyped. Spontaneous
clearance occurred in 17.6% of cases, 13.0% of cases expired prior to treatment, 14.4% had been treated
and cured. Local HCV prevalence was 0.25% with only 31.3% of cases connected to care at the time of
review. Among prevalent cases, 70.4% were thought to be substance use-related.
In the absence of a central comprehensive health record, determining the actual prevalence of HCV is
difficult. However, in order to meaningfully gauge progress toward HCV elimination and effectively map
and implement elimination strategies, having knowledge of prevalence is essential.
Disclose of interest: none

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