Contextualizing Canada's hepatitis C virus epidemic

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Policy

Background:

• Canada committed to the World Health Organization's 2030 hepatitis C virus (HCV) elimination targets in 2016.
• The majority of Canada's HCV burden resides within five key populations.
• These populations face unique barriers to prevention, diagnosis, and treatment.

Purpose of the Study:

• To describe the current state of the HCV epidemic in Canada.
• To highlight the disproportionate impact of HCV on specific vulnerable groups.
• To inform the development of a comprehensive HCV elimination strategy.

Main Methods:

• This is a review article.
• It synthesizes existing data on HCV epidemiology in Canada.
• It focuses on the challenges and needs of disproportionately affected populations.

Main Results:

• Baby Boomers require screening due to risks of cirrhosis and liver cancer.
• People who inject drugs (PWID) face mortality from HCV, acquisition, and co-infections, necessitating harm reduction and syndemic approaches.
• Indigenous populations, immigrants, and incarcerated individuals require culturally appropriate, wellness-based, and accessible services for effective HCV management.

Conclusions:

• Achieving the 2030 HCV elimination targets necessitates a comprehensive framework addressing prevention, care, and treatment for vulnerable populations.
• Integrated, syndemic-based solutions are crucial, particularly for PWID facing the opioid crisis.
• Culturally sensitive and accessible services are essential for Indigenous peoples, immigrants, and those in the justice system to reduce HCV burden and mortality.