A population-based study of chronic hepatitis C in immigrants and non-immigrants in Quebec, Canada

BMC Infectious Diseases

Research Article

Claire Nour Abou Chakra¹  Viet Anh Tran¹  Russ Steele²  Laurent Azoulay³  Robert Allard⁴  Christina Greenaway⁵  Marina Klein⁶  Joseph Cox⁷ 

[1] Centre for Clinical Epidemiology, Lady Davis Research Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Canada;Centre for Clinical Epidemiology, Lady Davis Research Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Canada;Department of Mathematics and Statistics, McGill University, Montreal, Canada;Centre for Clinical Epidemiology, Lady Davis Research Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Canada;Department of Oncology, McGill University, Montreal, Canada;Department of Oncology, McGill University, Montreal, Canada;Montreal Public Health Department, Montreal, Canada;Division of Infectious Diseases, Jewish General Hospital, McGill University, 3755 Côte St. Catherine Road, Room E-0057, PQ H3T 1E2, Montreal, Canada;Centre for Clinical Epidemiology, Lady Davis Research Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Canada;Division of Infectious Diseases, McGill University Health Center, McGill University, Montreal, Canada;Sexually Transmitted Infections Division, Montreal Public Health Department, Montreal, Canada;

关键词: Hepatitis C;    Immigrant;    Incidence;    Rates;    Viral hepatitis;   

DOI  :  10.1186/s12879-017-2242-y

 received in 2016-12-01, accepted in 2017-02-02,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundImmigrants originating from intermediate and high HCV prevalence countries may be at increased risk of exposure to hepatitis C infection (HCV) in their countries of origin, however they are not routinely screened after arrival in most low HCV prevalence host countries. We aimed to describe the epidemiology of HCV in immigrants compared to the Canadian born population.MethodsUsing the reportable infectious disease database linked to the landed immigration database and several provincial administrative databases, we assembled a cohort of all reported cases of HCV in Quebec, Canada (1998–2008). Underlying co-morbidities were identified in the health services databases. Stratum specific rates of reported cases/100,000, rate ratios (RRs) and trends over the study period were estimated.ResultsA total of 20,862 patients with HCV were identified, among whom 1922 (9.2%) were immigrants. Immigrants were older and diagnosed a mean of 9.8 ± 7 years after arrival. The Canadian born population was more likely to have behavior co-morbidities (problematic alcohol or drug use) and HIV co-infection. Immigrants from Sub-Saharan Africa, Asia and Eastern Europe had the highest HCV reported rates with RRs compared to non-immigrants ranging from 1.5 to 1.7. The age and sex adjusted rates decreased by 4.9% per year in non-immigrants but remained unchanged in immigrants. The proportion of HCV occurring in immigrants doubled over the study period from 5 to 11%.ConclusionsImmigrants from intermediate and high HCV prevalence countries are at increased risk for HCV and had a mean delay in diagnosis of almost 10 years after arrival suggesting that they may benefit from targeted HCV screening and earlier linkage to care.

【 授权许可】

CC BY   
© The Author(s). 2017