Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada.
Public Health Ontario Laboratory, Toronto, Ontario, Canada.
J Viral Hepat. 2022 Mar;29(3):205-208. doi: 10.1111/jvh.13637. Epub 2021 Dec 5.
The COVID-19 pandemic interrupted routine healthcare services. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are often asymptomatic, and therefore, screening and on/post-treatment monitoring are required. Our aim was to determine the effect of the first, second and third waves of the pandemic on HBV and HCV testing in Ontario, Canada. We extracted data from Public Health Ontario for HBV and HCV specimens from 1 January 2019 to 31 May 2021. Testing volumes were evaluated and stratified by age, sex and region. Changes in testing volumes were analysed by per cent and absolute change. Testing volumes decreased in April 2020 with the first wave of the pandemic and recovered to 72%-75% of prepandemic volumes by the end of the first wave. HBsAg testing decreased by 33%, 18% and 15%, and HBV DNA testing decreased by 37%, 27% and 20%, in each consecutive wave. Anti-HCV testing decreased by 35%, 21% and 19%, and HCV RNA testing decreased by 44%, 30% and 36% in each consecutive wave. These trends were consistent by age, region and sex. Prenatal HBV testing volumes were stable. In conclusion, significant decreases in HBV and HCV testing occurred during the first three waves of the pandemic and have not recovered. In addition to direct consequences on viral hepatitis elimination efforts, these data provide insight into the impacts of the pandemic on chronic disease screening and management. Strategies to make up for missed testing will be critical to avoid additional consequences of COVID-19 long after the pandemic has resolved.
新冠疫情大流行打乱了常规医疗服务。乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染通常无症状，因此需要进行筛查和治疗后监测。我们的目的是确定加拿大安大略省第一、二、三波疫情对 HBV 和 HCV 检测的影响。我们从安大略省公共卫生局提取了 2019 年 1 月 1 日至 2021 年 5 月 31 日 HBV 和 HCV 标本的数据。根据年龄、性别和地区对检测量进行评估和分层。通过百分比和绝对变化分析检测量的变化。随着第一波疫情的到来，2020 年 4 月检测量下降，并在第一波疫情结束时恢复到疫情前的 72%-75%。在每一波疫情中，HBsAg 检测量分别下降了 33%、18%和 15%，HBV DNA 检测量分别下降了 37%、27%和 20%。抗-HCV 检测量分别下降了 35%、21%和 19%，HCV RNA 检测量分别下降了 44%、30%和 36%。这些趋势在年龄、地区和性别上是一致的。产前 HBV 检测量保持稳定。总之，在疫情的前三波中，HBV 和 HCV 检测量显著下降，且尚未恢复。除了对病毒性肝炎消除工作的直接影响外，这些数据还提供了对大流行对慢性病筛查和管理影响的深入了解。制定弥补漏检的策略对于避免 COVID-19 大流行结束后长期产生的额外后果至关重要。
