Evaluating the hepatitis C care cascade in Newfoundland and Labrador: Progress toward elimination

Care cascades are useful tools for tracking progress toward public health goals, including the World Health Organization's target of hepatitis C elimination by 2030. This study outlines the hepatitis C care cascade in Newfoundland and Labrador (NL) from 2018 to 2024 and assesses trends in access to testing and treatment.

Provincial administrative health data on hepatitis C testing and treatment dispensing were analyzed. We calculated descriptive statistics for the full study period and compared two time intervals, with additional year-by-year analyses to examine trends.

From 2018 to 2024, the annual incidence of hepatitis C antibody positivity was 67.3 per 100,000 population. The diagnosis rate was 71%, and 25.6% of diagnosed individuals initiated treatment. Among those testing positive, the mean age was 40 years, 61% were male, and 31.5% were born between 1945 and 1975. Compared with 2018-2021, access to confirmatory RNA testing and treatment initiation improved in 2022-2024. Yearly trends showed steady increases in testing and treatment uptake, along with shorter time to treatment; by 2023, most individuals began treatment within 1 year of diagnosis.

While access to testing and treatment improved over time, NL has not yet met hepatitis C elimination targets. Targeted interventions for higher-risk populations are needed to accelerate progress.