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The Importance of Prisons in Achieving Hepatitis C Elimination: Insights from the Australian Experience. Viruses 2022; 14:v14030497. [PMID: 35336905 PMCID: PMC8949789 DOI: 10.3390/v14030497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 02/07/2023] Open
Abstract
Following the availability of highly effective direct-acting antivirals (DAAs) to treat hepatitis C infection, the uptake of treatment by people living with hepatitis C rose dramatically in high- and middle-income countries but has since declined. To achieve the World Health Organization’s (WHO) 2030 target to eliminate hepatitis C as a public health threat among people who inject drugs, an increase in testing and treatment is required, together with improved coverage of harm reduction interventions. The population that remains to be treated in high- and middle-income countries with high hepatitis C prevalence are among the most socially disadvantaged, including people who inject drugs and are involved in the criminal justice system, a group with disproportionate hepatitis C prevalence, compared with people in the wider community. Imprisonment provides an unrivalled opportunity for screening and treating large numbers of people for hepatitis C, who may not access mainstream health services in the community. Despite some implementation challenges, evidence of the efficacy, acceptability, and cost-effectiveness of in-prison hepatitis treatment programs is increasing worldwide, and evaluations of these programs have demonstrated the capacity for treating people in high numbers. In this Perspective we argue that the scale-up of hepatitis C prevention, testing, and treatment programs in prisons, along with the investigation of new and adapted approaches, is critical to achieving WHO elimination goals in many regions; the Australian experience is highlighted as a case example. We conclude by discussing opportunities to improve access to prevention, testing, and treatment for people in prison and other justice-involved populations, including harnessing the changed practices brought about by the COVID-19 pandemic.
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Bartlett SR, Buxton J, Palayew A, Picchio CA, Janjua NZ, Kronfli N. Hepatitis C Virus Prevalence, Screening, and Treatment Among People Who Are Incarcerated in Canada: Leaving No One Behind in the Direct-Acting Antiviral Era. Clin Liver Dis (Hoboken) 2021; 17:75-80. [PMID: 33680440 PMCID: PMC7916434 DOI: 10.1002/cld.1023] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/21/2020] [Accepted: 08/02/2020] [Indexed: 02/04/2023] Open
Affiliation(s)
- Sofia R. Bartlett
- Department of Pathology and Laboratory MedicineFaculty of MedicineUniversity of British ColumbiaVancouverBCCanada
- The Kirby InstituteUniversity of New South WalesSydneyAustralia
- British Columbia Centre for Disease ControlProvincial Health Services AuthorityVancouverBCCanada
| | - Jane Buxton
- British Columbia Centre for Disease ControlProvincial Health Services AuthorityVancouverBCCanada
- School of Population and Public HealthFaculty of MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Adam Palayew
- Department of Epidemiology, Biostatistics, and Occupational HealthMcGill UniversityMontrealQCCanada
| | - Camila A. Picchio
- Barcelona Institute for Global Health (ISGlobal)Hospital ClínicUniversity of BarcelonaBarcelonaSpain
| | - Naveed Z. Janjua
- British Columbia Centre for Disease ControlProvincial Health Services AuthorityVancouverBCCanada
- School of Population and Public HealthFaculty of MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Nadine Kronfli
- Department of MedicineDivision of Infectious Diseases and Chronic Viral Illness ServiceMcGill UniversityMontrealQCCanada
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Paynter M, Heggie C, McKibbon S, Martin-Misener R, Iftene A, Murphy GT. Sexual and Reproductive Health Outcomes among Incarcerated Women in Canada: A Scoping Review. Can J Nurs Res 2021; 54:72-86. [PMID: 33508956 DOI: 10.1177/0844562120985988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Women are the fastest growing population in Canadian prisons. Incarceration can limit access to essential health services, increase health risks and disrupt treatment and supports. Despite legal requirements to provide care at professionally accepted standards, evidence suggests imprisonment undermines sexual and reproductive health. This scoping review asks, "What is known about the sexual and reproductive health of people incarcerated in prisons for women in Canada?" METHODS We use the Joanna Briggs Institute methodology for systematic scoping reviews. Databases searched include MEDLINE, CINAHL, PsycINFO, Gender Studies Abstracts, Google Scholar and Proquest Dissertations and grey literature. The search yielded 1424 titles and abstracts of which 15 met the criteria for inclusion. RESULTS Conducted from 1994-2020, in provincial facilities in Ontario, British Columbia, Alberta and Quebec as well as federal prisons, the 15 studies included qualitative, quantitative and mixed methods. The most common outcomes of interest were related to HIV. Other outcomes studied included Papanicolaou (Pap) and sexually transmitted infection (STI) testing, contraception, pregnancy, birth/neonatal outcomes, and sexual assault. CONCLUSION Incarceration results in lack of access to basic services including contraception and prenatal care. Legal obligations to provide sexual and reproductive health services at professionally acceptable standards appear unmet. Incarceration impedes rights of incarcerated people to sexual and reproductive health.
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Affiliation(s)
- Martha Paynter
- School of Nursing, Dalhousie University, Halifax, NS, Canada.,School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Clare Heggie
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | | | | | - Adelina Iftene
- Health Law Institute, Schulich School of Law, Halifax, NS, Canada
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Van Meer R, Antoniou T, McCormack D, Khanna S, Kendall C, Kiefer L, Kouyoumdjian FG. A comparison of the observed and expected prevalence of HIV in persons released from Ontario provincial prisons in 2010. Canadian Journal of Public Health 2019; 110:675-682. [PMID: 31250354 DOI: 10.17269/s41997-019-00233-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 05/23/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To estimate the prevalence of HIV infection in persons released from Ontario prisons in 2010 using administrative health data, and to compare this observed prevalence with the expected prevalence based on the most recently available biological sampling data. METHODS We linked identifying data for all adults released from Ontario provincial prisons in 2010 with administrative health data, and applied a validated algorithm to determine the observed HIV prevalence. We calculated the expected HIV prevalence using 2003-2004 age stratum-specific data from a published study using salivary sampling. We calculated an indirect standardized prevalence ratio of the observed to expected prevalence and 95% confidence intervals. Finally, we conducted sensitivity analyses to adjust for the sensitivity of the algorithm to identify persons with HIV and for undiagnosed HIV infection. RESULTS Of 52,313 persons released from Ontario prisons in 2010, we identified 363 persons with HIV, for an observed prevalence of 0.69%. The expected prevalence was 2.38%. Standardized for age, we found a prevalence ratio of 0.29 (95% CI, 0.17-0.77). Sensitivity analyses adjusting for the algorithm's sensitivity and further adjusting for undiagnosed HIV infection produced standardized prevalence ratios of 0.30 and 0.38, respectively. CONCLUSION Our findings suggest that a high proportion of persons with HIV recently released from provincial prisons either do not know they have HIV infection or do know about their infection but are not engaged in care. Interventions are required to screen people for HIV in prison and to link persons with care following release.
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Affiliation(s)
- Ryan Van Meer
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Tony Antoniou
- ICES, Toronto, Ontario, Canada.,Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | | | - Sumeet Khanna
- Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto, Canada
| | - Claire Kendall
- ICES, Toronto, Ontario, Canada.,C.T. Lamont Primary Health Care Research Group, Bruyère Research Institute, Ottawa, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Lori Kiefer
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Ministry of Community Safety and Correctional Services, Toronto, Ontario, Canada
| | - Fiona G Kouyoumdjian
- ICES, Toronto, Ontario, Canada. .,Department of Family Medicine, McMaster University, 100 Main Street West, Hamilton, Ontario, L8P 1H6, Canada. .,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada.
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5
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Courtemanche Y, Poulin C, Serhir B, Alary M. HIV and hepatitis C virus infections in Quebec's provincial detention centres: comparing prevalence and related risky behaviours between 2003 and 2014-2015. Canadian Journal of Public Health 2018; 109:353-361. [PMID: 29981093 DOI: 10.17269/s41997-018-0047-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 12/23/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To compare the prevalence of HIV, hepatitis C virus (HCV) infections, and related risky behaviours among inmates in Quebec's provincial prisons between 2003 and 2014-2015. METHODS Cross-sectional data were anonymously collected from May 2014 to March 2015 for men (n = 1315) and women (n = 250) and combined with data collected in 2003 to evaluate trends in the last decade. Participants completed a questionnaire and provided saliva samples. The data from the 2003 and 2014-2015 surveys were merged for statistical analysis. RESULTS HIV prevalence was stable between 2003 and 2014-2015 for men (2.4% vs. 1.8%, p = 0.4), whereas it decreased for women (8.8% vs. 0.8%, p < 0.001). HCV prevalence decreased between 2003 and 2014-2015 for both men (16.6% vs. 11.9%, p < 0.001) and women (29.2% vs. 19.2%, p = 0.02). HIV and HCV prevalence were higher among people who inject drugs (PWID), for both sexes and both studies. PWID-specific prevalence did not change between 2003 and 2014-2015, except for a decrease in HIV prevalence in PWID women. However, the proportion of prisoners reporting a history of injection drug use outside prison was lower in 2014-2015 than in 2003 for men (19.8% vs. 27.7%, p < 0.0001) and women (28.6% vs. 42.6%, p = 0.002). CONCLUSION The lower proportion of PWID inmates in 2014-2015 compared to 2003 explained in large part the decrease in HIV and HCV prevalence. Despite the decrease in prevalence, HIV and HCV infections among incarcerated individuals still represent a major public health problem due to the sizable increase of individuals in Quebec's correctional system over the same period.
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Affiliation(s)
- Yohann Courtemanche
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Céline Poulin
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Bouchra Serhir
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne de Bellevue, Canada
| | - Michel Alary
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada. .,Département de médecine sociale et préventive, Université Laval, Québec, Canada. .,Institut national de santé publique du Québec, Québec, Canada. .,Centre de recherche du CHU de Québec, Hôpital du Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC, G1S 4L8, Canada.
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6
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Poulin C, Courtemanche Y, Serhir B, Alary M. Tattooing in prison: a risk factor for HCV infection among inmates in the Quebec's provincial correctional system. Ann Epidemiol 2018; 28:231-235. [PMID: 29576049 DOI: 10.1016/j.annepidem.2018.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 01/31/2018] [Accepted: 02/07/2018] [Indexed: 01/17/2023]
Abstract
PURPOSE To determine the prevalence of hepatitis C virus (HCV) and identify related risk factors among inmates in Quebec provincial prisons. METHODS Anonymous cross-sectional data were collected between May 2014 and March 2015 for 1315 men and 250 women who completed a questionnaire and provided oral fluid samples. RESULTS The global prevalence of HCV infection was 11.9% in male participants and 19.2% in female participants (P = .003). Among people who inject drugs (PWID), the prevalence was much higher compared to that in persons who does not: 51.0% versus 2.4% in men (P < .001) and 61.4% versus 2.8% in women (P < .001). In the multivariable analysis, lifetime history of injection drug use was the most important risk factor for HCV infection (adjusted odds ratio [AOR]: 14.2; 95% confidence interval [95% CI]: 9.5-21.4), with needle sharing significantly associated with HCV among PWID (AOR: 1.4; 95% CI: 1.1-1.7). Tattooing in prison was frequent, especially among men (37.2%), and independently associated with HCV infection among non-PWID (AOR: 2.8; 95% CI: 1.4-5.6). CONCLUSION Inmates are at high risk for HCV infection especially because of a high proportion of active or past PWID among them. In addition, tattooing while in prison seems to contribute to HCV infection among non-PWID.
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Affiliation(s)
- Céline Poulin
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Yohann Courtemanche
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Bouchra Serhir
- Laboratoire de santé publique du Québec, Institut national de Santé publique du Québec, Sainte-Anne de Bellevue, Canada
| | - Michel Alary
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Département de médecine sociale et préventive, Université Laval, Québec, Canada; Institut national de santé publique du Québec, Québec, Canada.
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7
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Puga MAM, Bandeira LM, Pompilio MA, Croda J, de Rezende GR, Dorisbor LFP, Tanaka TSO, Cesar GA, Teles SA, Simionatto S, Novais ART, Nepomuceno B, Castro LS, do Lago BV, Motta-Castro ARC. Prevalence and Incidence of HCV Infection among Prisoners in Central Brazil. PLoS One 2017; 12:e0169195. [PMID: 28060860 PMCID: PMC5218405 DOI: 10.1371/journal.pone.0169195] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 12/10/2016] [Indexed: 12/12/2022] Open
Abstract
The aim of this multicenter, cross sectional study was to assess the prevalence, incidence and associated risk factors among incarcerated populations from twelve Brazilian prisons. The total of 3,368 individuals from twelve prisons was randomly recruited between March 2013 and March 2014. Participants were interviewed, and provided blood samples which were tested for antibodies to Hepatitis C (HCV ab). One year after the first investigation, a cohort study was conducted with 1,656 inmates who participated the cross sectional study. Positive samples were tested for the presence of HCV RNA. Out of 3,368 inmates, 520 (15.4%) were females, and 2,848 (84.6%) were males. The overall prevalence of HCV was 2.4% (95% CI: 1.9 to 2.9), with 0.6% (95% CI: 0.4 to 0.8) in females, and 2.7% (95% CI: 2.1 to 3.3) in males (p<0.01). HCV RNA was detected in 51/80 (63.7%) samples. Among men prisoners, multivariate analysis of associated factors showed independent associations between HCV exposure and increasing age, inject drug use, length of incarceration, smoking hashish, sharing needle and syringe and HIV positivity. During the cohort study, 7/1,656 new cases of HCV infection were detected, and the incidence rate was 0.4/100 person-year. Once high frequency rates of specific HCV risk behaviors and new HCV infections have been identified inside prisons, effective interventions strategies such as screening, clinical evaluation and treatment to reduce the spread of HCV infection are essential.
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Affiliation(s)
| | | | | | - Julio Croda
- Oswaldo Cruz Foundation, Mato Grosso do Sul, MS, Brazil
- Federal University of Grande Dourados, Dourados, MS, Brazil
| | | | | | | | | | | | | | | | - Bruna Nepomuceno
- Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | | | | | - Ana Rita Coimbra Motta-Castro
- Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
- Oswaldo Cruz Foundation, Mato Grosso do Sul, MS, Brazil
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Abstract
PURPOSE OF REVIEW This review will give an update on the prevalence of HIV/hepatitis C virus (HCV) coinfection, and describe recent trends in all-cause and cause-specific mortality. The focus is mainly on patients followed in clinics in high-income countries and their heterogeneity in terms of risk factors and clinical outcomes. RECENT FINDINGS In countries that have introduced comprehensive preventive strategies for injection drug users, the prevalence of HIV/HCV coinfection has declined. Compared with HIV monoinfected patients, the mortality among HCV-coinfected patients remains markedly increased because of multiple risk factors, in particular among drug users. The spectrum of causes of death among coinfected has recently been described in large cohort studies. Around a quarter of all deaths were liver related, and the incidence has decreased in Western Europe and stabilized in Eastern Europe where AIDS remains the dominant cause of death. In North America, the incidence of end-stage liver disease has not decreased despite improvements in HIV care. HCV treatment seems to have had little effect thus far on mortality at the population level. SUMMARY Despite a decreasing prevalence of HIV/HCV coinfection in many countries, coinfection remains an important clinical problem that requires a multidisciplinary approach including direct-acting antivirals for those at risk of liver-related death.
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9
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HIV/AIDS prevalence in Israeli prisons: Is there a need for universal screening? J Public Health Policy 2015. [PMID: 26202863 DOI: 10.1057/jphp.2015.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This study aimed to assess HIV/AIDS point-prevalence among inmates and evaluate costs related to universal screening as currently practiced and appraise its necessity. All inmates newly incarcerated in Israel (2003-2010) underwent HIV tests and their medical files were cross-matched the with the national HIV/AIDS registry to who had been newly infected and detected on prison entry. They were classified by key risk-groups. Of 108,866 new inmates during the period, 215 (0.2 per cent) were diagnosed with HIV/AIDS, 44 of those (0.04 per cent) were not aware of their infection. A large majority (94.2 per cent) of the infected inmates were members of a key-risk group: drug-users, homosexuals, or originating from a high-HIV prevalence country. The direct cost of detecting a single HIV-infected inmate who was not previously recorded was [euro ]12,386. The HIV/AIDS-screening process can be improved by interviewing the new inmates and performing targeted HIV-testing for those who are members of a known risk-group. These data from Israel are pertinent to developed countries with low HIV prevalence, because they present a picture of all newly infected inmates over an 8-year period within the paradigm of a fully functional HIV surveillance system.
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10
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Estimated prevalence of Hepatitis C Virus infection in Canada, 2011. ACTA ACUST UNITED AC 2014; 40:429-436. [PMID: 29769874 DOI: 10.14745/ccdr.v40i19a02] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Prevalence estimates contribute to our understanding of the magnitude of a particular health condition and in planning appropriate public health interventions. Objective To estimate the prevalence of chronic Hepatitis C virus (HCV) infection, anti-HCV-positive status (anti-HCV) and the proportion of undiagnosed HCV infections in Canada. Methods A combination of back-calculation and workbook methods was used. The back-calculation method estimated prevalent chronic HCV infection and the proportion undiagnosed using the Canadian Cancer Registry's data on hepatocellular carcinoma reported between 1992 and 2008 and the Canadian Notifiable Disease Surveillance System's data on Hepatitis C virus (HCV) cases reported between 1991 and 2009 in a Markov multi-state disease progression model with parameters adjusted to Canada. The workbook method divided the total population of Canada into population subsets and developed estimates of population size and anti-HCV prevalence for each. Sub-population size estimates were multiplied by anti-HCV prevalence measures to calculate the prevalence of anti-HCV by sub-population. A measure of spontaneous clearance was used to estimate the number of persons with chronic HCV from estimates of the number of anti-HCV-positive persons. Results The back-calculation method estimated the prevalence of chronic HCV infection at 0.64% and the proportion of undiagnosed chronic HCV infection at 44% in 2011. The workbook method estimated the anti-HCV prevalence at 0.96% (plausibility range: 0.61% to 1.34%) and chronic HCV infection at 0.71% (0.45 - 0.99%). Interpretation By combining mid-point estimates from both methods, it is estimated that between 0.64% to 0.71% of the overall Canadian population was living with chronic HCV infection in 2011 and 44% of these individuals were undiagnosed.
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Trubnikov M, Yan P, Njihia J, Archibald C. Identifying and describing a cohort effect in the national database of reported cases of hepatitis C virus infection in Canada (1991-2010): an age-period-cohort analysis. CMAJ Open 2014; 2:E281-7. [PMID: 25485255 PMCID: PMC4251503 DOI: 10.9778/cmajo.20140041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) infection has a high likelihood of becoming chronic and lead to a range of conditions with poor health outcomes. Identifying birth groups highly affected by HCV infection may better focus public health interventions and ensure their cost-effectiveness. Our analysis focused on studying the association of the birth year and reporting period with rates of cases of HCV infection reported in Canada over a 20-year period. METHODS Laboratory-confirmed acute or chronic HCV cases with information on sex, age and year of report from 6 provinces and territories that reported line-listed data to the Canadian Notifiable Diseases Surveillance System from 1991 to 2010 were used. Sex-specific infection rates for 5-year birth groups born between 1921 and 1990 were calculated. Rates of HCV infection were log-logit transformed and underwent mean polish analysis and panel linear regression. Rate ratios of HCV infection in the 5-year age groups and their 95% confidence intervals were calculated, with rates in males and females born in 1941-1945 used as references. RESULTS Males born between 1946 and 1970 had 21%-40% higher reported rates of HCV infection, whereas females born between 1946 and 1975 had 12%-43% higher reported rates compared with rates in the respective sexes who were born in 1941-1945. INTERPRETATION Individuals born between 1946 and 1965 contributed the most to the rates of HCV infection reported in Canada between 1991 and 2010. The cohort effect was present in male and female cases of HCV infection with birth year up to 1970 and 1975, respectively. Our findings will support the development of HCV prevention programs and policies in Canada.
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Affiliation(s)
- Max Trubnikov
- Public Health Agency of Canada − Centre for Communicable Diseases and Infection Control
Ottawa, Ont
| | - Ping Yan
- Public Health Agency of Canada − Centre for Communicable Diseases and Infection Control
Ottawa, Ont
| | - Jane Njihia
- Public Health Agency of Canada − Centre for Communicable Diseases and Infection Control
Ottawa, Ont
| | - Chris Archibald
- Public Health Agency of Canada − Centre for Communicable Diseases and Infection Control
Ottawa, Ont
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12
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Hepatitis C infection among pregnant women in British Columbia: reported prevalence and critical appraisal of current prenatal screening methods. Canadian Journal of Public Health 2011. [PMID: 21608379 DOI: 10.1007/bf03404155] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Despite the fact that hepatitis C virus (HCV) is a relatively common infection in Canada, particularly in British Columbia (BC), there is a paucity of information on actual HCV prevalence in pregnant women. At present, pregnant women are only screened if they fit risk criteria, which may result in under-identification of HCV in this population. The purpose of this study was to determine the overall prevalence rate, age and geographic distribution of reported HCV infection among pregnant women in BC, and compare results to a previously conducted anonymous seroprevalence survey. METHODS Reported HCV prevalence was determined through a confidential database linkage of all prenatal screening results at the Canadian Blood Services (CBS) with all HCV test results at the Provincial Laboratory, from May 2000 to Oct 2002. Data were stratified by age group and geographic location, and subsequently compared to an anonymous prenatal seroprevalence survey conducted in 1994. RESULTS The overall HCV prevalence rate was 50.3/10,000 (95% CI 46.3-54.6), or 0.5% of the cohort. Prevalence was highest in the northern BC region (66.2/10,000, 95% CI 51.4-85.3) and lowest in the populous suburban region southwest of Vancouver (38.0/10,000, 95% CI 32.3-44.8). Of note, the rate of reported HCV among pregnant women was significantly lower than the anonymous seroprevalence rate: 50.3/10,000 vs. 91.3/10,000 (p < 0.0001). CONCLUSION Rates of reported HCV among pregnant women were approximately 50% lower than the rates determined by the anonymous seroprevalence survey. Further research is needed to determine the relative merits of the current selective screening policy versus universal prenatal HCV screening in pregnancy.
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Poulin C, Alary M, Lambert G, Godin G, Landry S, Gagnon H, Demers E, Morarescu E, Rochefort J, Claessens C. Prevalence of HIV and hepatitis C virus infections among inmates of Quebec provincial prisons. CMAJ 2007; 177:252-6. [PMID: 17664448 PMCID: PMC1930200 DOI: 10.1503/cmaj.060760] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND To determine the prevalence of HIV and hepatitis C virus (HCV) infections and examine risk factors for these infections among inmates in Quebec provincial prisons. METHODS Anonymous cross-sectional data were collected from January to June 2003 for men (n = 1357) and women (n = 250) who agreed to participate in the study and who completed a self-administrated questionnaire and provided saliva samples. RESULTS The prevalence of HIV infection was 2.3% among the male participants and 8.8% among the female participants. The corresponding prevalence of HCV infection was 16.6% and 29.2%, respectively. The most important risk factor was injection drug use. The prevalence of HIV infection was 7.2% among the male injection drug users and 0.5% among the male non-users. Among the women, the rate was 20.6% among the injection drug users, whereas none of the non-users was HIV positive. The prevalence of HCV infection was 53.3% among the male injection drug users and 2.6% among the male non-users; the corresponding values among the women were 63.6% and 3.5%. INTERPRETATION HIV and HCV infections constitute an important public health problem in prison, where the prevalence is affected mainly by a high percentage of injection drug use among inmates.
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Affiliation(s)
- Céline Poulin
- Unité de recherche en santé des populations, Centre hospitalier universitaire de Québec, Québec, Que
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14
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Calzavara L, Ramuscak N, Burchell AN, Swantee C, Myers T, Ford P, Fearon M, Raymond S. Prevalence of HIV and hepatitis C virus infections among inmates of Ontario remand facilities. CMAJ 2007; 177:257-61. [PMID: 17664449 PMCID: PMC1930192 DOI: 10.1503/cmaj.060416] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Each year more than 56 000 adult and young offenders are admitted to Ontario's remand facilities (jails, detention centres and youth centres). The prevalence of HIV infection in Ontario remand facilities was last measured over a decade ago, and no research on the prevalence of hepatitis C virus (HCV) infection has been conducted in such facilities. We sought to determine the prevalence of HIV infection, HCV infection and HIV-HCV coinfection among inmates in Ontario's remand facilities. METHODS A voluntary and anonymous cross-sectional prevalence study of HIV and HCV infections was conducted among people admitted to 13 selected remand facilities across Ontario between Feb. 1, 2003, and June 20, 2004. Data collection included a saliva specimen for HIV and HCV antibody screening and an interviewer-administered survey. Prevalence rates and 95% confidence intervals were calculated and examined according to demographic characteristics, region of incarceration and self-reported history of injection drug use. RESULTS In total, 1877 participants provided both a saliva specimen and survey information. Among the adult participants, the prevalence of HIV infection was 2.1% among men and 1.8% among women. Adult offenders most likely to have HIV infection were older offenders (> or = 30 years) and injection drug users. The prevalence of HCV infection was 15.9% among men, 30.2% among women and 54.7% among injection drug users. Adult offenders most likely to have HCV infection were women, older offenders (> or = 30 years) and injection drug users. The prevalence of HCV-HIV coinfection was 1.2% among men and 1.5% among women. It was highest among older inmates and injection drug users. Among the young offenders, none was HIV positive and 1 (0.4%) was HCV positive. On the basis of the study results, we estimated that 1079 HIV-positive adults and 9208 HCV-positive adults were admitted to remand facilities in Ontario from Apr. 1, 2003, to Mar. 31, 2004. INTERPRETATION Adult offenders entering Ontario remand facilities have a considerably higher prevalence of HIV and HCV infections than the general population.
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Affiliation(s)
- Liviana Calzavara
- HIV Social, Behavioural and Epidemiological Studies Unit, Faculty of Medicine, University of Toronto, Toronto, Ont.
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Farley J, Vasdev S, Fischer B, Haydon E, Rehm J, Farley TA. Feasibility and outcome of HCV treatment in a Canadian federal prison population. Am J Public Health 2005; 95:1737-9. [PMID: 16131642 PMCID: PMC1449428 DOI: 10.2105/ajph.2004.056150] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We assessed feasibility and outcome of hepatitis C virus (HCV) treatment in male correctional inmates in British Columbia, Canada. We reviewed the medical charts of 114 treated inmates; 80 had complete data for treatment outcome. Approximately 4 of 5 inmates completed treatment (78.8%); 66.3% achieved sustained virological response. Those who completed treatment, those with injection drug use as a risk factor, and those with genotypes 2 and 3 were significantly more likely to achieve sustained virological response. HCV treatment in correctional inmates is feasible and effective.
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Affiliation(s)
- John Farley
- University of British Columbia, Vancouver, BC, Canada
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