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Estimating chronic hepatitis C prevalence in British Columbia and Ontario, Canada, using population-based cohort

Abdullah Hamadeh1, Alex Haines2, Zeny Feng3

  • 1School of Pharmacy, University of Waterloo, Kitchener, ON, Canada.

Journal of Viral Hepatitis
|August 19, 2020
PubMed

Insights

Estimating chronic hepatitis C (CHC) prevalence in Canada reveals significant undiagnosed cases. This research informs public health strategies for CHC elimination targets.

Area of Science:

  • Public Health
  • Epidemiology
  • Health Services Research

Background:

  • Direct-acting antiviral agents offer effective treatment for chronic hepatitis C (CHC).
  • A significant burden of subclinical, undetected CHC infection persists.
  • Accurate prevalence and undiagnosed proportions are crucial for public health interventions.

Purpose of the Study:

  • To estimate the prevalence and undiagnosed proportion of CHC in British Columbia and Ontario, Canada.
  • To provide evidence for policymakers to develop targeted strategies for CHC elimination.
  • To demonstrate a model-based approach integrating health administrative data for epidemiological estimation.

Main Methods:

  • A two-step model-based approach was employed.
  • Retrospective analysis of provincial population-level health administrative data for CHC patients.
  • Utilized a validated natural history model of hepatitis C virus (HCV) infection to back-calculate historical prevalence.

Main Results:

  • In 2014, CHC prevalence was 1.04% in British Columbia and 0.91% in Ontario.
  • Approximately 33.3% of CHC cases were undiagnosed in British Columbia and 36.0% in Ontario.
  • Newly diagnosed CHC cases are declining annually, while disease complications are increasing.

Conclusions:

  • The study provides robust estimates of CHC prevalence and undiagnosed proportions by integrating a natural history model with health administrative data.
  • The findings highlight the need for continued efforts to identify and treat undiagnosed CHC infections to meet elimination targets.
  • The methodology can be adapted to estimate CHC burden in other regions globally.

Keywords:
chronic hepatitis Cmathematical modellingpopulation-level health administrative dataprevalence

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