Twin epidemics of new and prevalent hepatitis C infections in Canada: BC Hepatitis Testers Cohort

BMC Infectious Diseases

Research Article

Darrel Cook¹  Jason Wong¹  Amanda Yu¹  Margot Kuo¹  Maria Alvarez¹  Mel Krajden²  Naveed Zafar Janjua³  Mark W. Tyndall³ 

[1] Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada;Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada;Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada;Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada;School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada;

关键词: HCV;    Hepatitis B;    HIV;    Epidemiology;    Screening;    Cohort study;   

DOI  :  10.1186/s12879-016-1683-z

 received in 2016-01-12, accepted in 2016-06-13,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundWe characterized the twin epidemics of new and prevalent hepatitis C virus (HCV) infections in British Columbia, Canada to inform prevention, care and treatment programs.MethodsThe BC Hepatitis Testers Cohort (BC-HTC) includes individuals tested for HCV, HIV or reported as a case of HBV, HCV, HIV or active TB between 1990–2013 linked with data on their medical visits, hospitalizations, cancers, prescription drugs and mortality. Prevalent infection was defined as being anti-HCV positive at first test. Those with a negative test followed by a positive test were considered seroconverters or new infections.ResultsOf 1,132,855 individuals tested for HCV, 64,634 (5.8 %) were positive and an additional 3092 cases tested positive elsewhere for a total of 67,726. Of 55,781 HCV positive individuals alive at the end of 2013, 7064 were seroconverters while 48,717 had prevalent infection at diagnosis. The HCV positivity rate (11.2 %) was highest in birth cohort 1945–1964 which declined over time. New infections were more likely to be male, 15–34 years of age (born 1965-1984), HIV- or HBV-coinfected, socioeconomically disadvantaged, have problematic drug and alcohol use and a mental health illness. The profile was similar for individuals with prevalent infection, except for lower odds of HBV-coinfection, major mental health diagnoses and birth cohort >1975.ConclusionsThe HCV positivity rate is highest in birth cohort 1945–1964 which represents most prevalent infections. New infections occur in younger birth cohorts who are commonly coinfected with HIV and/or HBV, socioeconomically marginalized, and living with mental illness and addictions.

【 授权许可】

CC BY   
© The Author(s). 2016