Estimated prevalence of Hepatitis C Virus infection in Canada, 2011

The Seroprevalence of Hepatitis C Antibodies in Immigrants and Refugees from Intermediate and High Endemic Countries: A Systematic Review and Meta-Analysis

BACKGROUND & AIMS

Hepatitis C virus (HCV) infection is a significant global health issue that leads to 350,000 preventable deaths annually due to associated cirrhosis and hepatocellular carcinoma (HCC). Immigrants and refugees (migrants) originating from intermediate/high HCV endemic countries are likely at increased risk for HCV infection due to HCV exposure in their countries of origin. The aim of this study was to estimate the HCV seroprevalence of the migrant population living in low HCV prevalence countries.

METHODS

Four electronic databases were searched from database inception until June 17, 2014 for studies reporting the prevalence of HCV antibodies among migrants. Seroprevalence estimates were pooled with a random-effect model and were stratified by age group, region of origin and migration status and a meta-regression was modeled to explore heterogeneity.

RESULTS

Data from 50 studies representing 38,635 migrants from all world regions were included. The overall anti-HCV prevalence (representing previous and current infections) was 1.9% (95% CI, 1.4-2.7%, I2 96.1). Older age and region of origin, particularly Sub-Saharan Africa, Asia, and Eastern Europe were the strongest predictors of HCV seroprevalence. The estimated HCV seroprevalence of migrants from these regions was >2% and is higher than that reported for most host populations.

CONCLUSION

Adult migrants originating from Asia, Sub-Saharan Africa and Eastern Europe are at increased risk for HCV and may benefit from targeted HCV screening.

Persons in correctional facilities in Canada: A key population for hepatitis C prevention and control

About one in nine Canadians who are infected with hepatitis C spend time in a correctional facility each year. With high rates of current injection drug use and needle sharing, this population may account for a large proportion of new infections. Any national strategy to address hepatitis C should include a focus on persons in correctional facilities, and should build on existing evidence regarding primary, secondary and tertiary prevention.

Hepatitis C surveillance in Canada

Background

Hepatitis C is a highly transmissible virus that can lead to chronic liver disease. It continues to be a major public health concern in Canada.

Objective

To describe surveillance trends of reported cases of Hepatitis C virus (HCV) in Canada by age and sex from 1991-2012.

Methods

Cases of HCV reported to the Canadian Notifiable Disease Surveillance System were compiled at the national level. As most reported cases are not differentiated by acute or chronic HCV infection status, presented results are based on total HCV cases. Time trends are provided from 1991-2012, with a more detailed examination of age and sex patterns from 2005-2012.

Results

The rate of reported HCV infection increased sharply from 1991 (the year it was first notifiable) until 1998, when the highest overall rate of 66.9 per 100,000 was observed. From that time until 2012, rates of reported cases decreased in both sexes, but remained consistently higher among males than females. In 2012, the overall rate of reported HCV infection was 29.3 per 100,000. In younger age groups, rates among females were marginally higher, while males in older age groups (30 and above) exhibited substantially higher rates.

Conclusion

This surveillance summary presents the longer-term trends in reported cases and corresponding rates of HCV in Canada using national surveillance data. Canada continues to experience a downward trend in HCV rates; however, the burden of infection will continue to increase as chronically infected individuals develop severe illness.

Distribution of Hepatitis C virus genotypes among newly acquired HCV infections in British Columbia (2000-2013)

BACKGROUND

Characterization of newly acquired Hepatitis C virus (HCV) infections is important in order to understand the epidemiology and spread of HCV.

OBJECTIVE

To describe the Hepatitis C virus (HCV) genotype distribution of newly acquired HCV infections in the province of British Columbia for the period 2000-2013.

METHODS

A descriptive cross-sectional analysis of multi-year data on HCV genotypes. Time trends for the proportion of different HCV genotypes are presented only for newly acquired (incident) HCV infections.

RESULTS

For acute cases, genotype 1a remains the dominant HCV type in circulation (50%), followed by genotype 3a (34%). HCV genotype 1b declined, while genotype 2 was relatively stable. Phylogenetically-related clusters of HCV strains were observed indicating a common source of infection.

CONCLUSION

Enhanced hepatitis surveillance provides a mechanism for monitoring different HCV strains currently circulating in the community. While HCV genotype 1a continues to be the most prevalent, changes in the relative frequency of genotypes 1 and 3 have been observed. This may have important implications for the control and prevention of the infection.