Forouzannia Farinaz, Lewis Diedron, Eze Nkiruka, Clement Fiona, Wong William W L
School of Pharmacy, University of Waterloo, Kitchener, ON, Canada.
Community Health Sciences, University of Calgary, Calgary, AB, Canada.
Can Liver J. 2025 Apr 11;8(2):344-354. doi: 10.3138/canlivj-2024-0062. eCollection 2025 May.
Understanding the impact of wider access to treatment on chronic hepatitis C (CHC) prevalence and the undiagnosed CHC proportion is important to achieving the World Health Organization's 2030 elimination targets. This research aimed to: (1) estimate the CHC prevalence and undiagnosed rates in Alberta, Canada; and (2) explore the impact of new direct-acting antiviral therapy on these rates since its introduction in 2014.
This study adopted a two-step approach to estimate CHC prevalence and undiagnosed rates. This involved a population-based retrospective analysis of health administrative data for Alberta from 2002 to 2018 to generate CHC-related events for three birth cohorts: individuals born before 1945, individuals born between 1945 and 1965, and individuals born after 1965. A back-calculation method was employed to obtain historical prevalence and incidence estimates.
After the introduction of direct-acting antiviral treatment in 2014, the mean prevalence of CHC over all the birth cohorts fell by approximately 6.5% from 1.23% (95% CI: 0.97%-1.5%) to 1.15% (95% CI: 0.91%-1.45%) between 2015 and 2018. Similar trends were estimated for the 1945-1965 and the >1965 birth cohorts over the same period. Likewise, the mean proportion of undiagnosed CHC infections over all the birth cohorts fell by approximately 8.25% from 39.36% (95% CI: 30.08%-48.48%) to 36.36% (95% CI: 27.49%-45.31%) over the same period. A similar trend was experienced in all three birth cohorts.
This is the first study to estimate CHC prevalence and undiagnosed proportions in Alberta using provincial health administrative data. These results could provide vital evidence to guide decisions about current and future hepatitis C virus strategies and help achieve the World Health Organization goal of eliminating hepatitis C in Canada by 2030.
了解扩大治疗可及性对慢性丙型肝炎（CHC）患病率和未诊断CHC比例的影响，对于实现世界卫生组织2030年消除目标至关重要。本研究旨在：（1）估计加拿大艾伯塔省的CHC患病率和未诊断率；（2）探讨自2014年新型直接作用抗病毒疗法引入以来对这些比率的影响。
本研究采用两步法来估计CHC患病率和未诊断率。这涉及对艾伯塔省2002年至2018年卫生行政数据进行基于人群的回顾性分析，以生成三个出生队列的CHC相关事件：1945年前出生的个体、1945年至1965年出生的个体以及1965年后出生的个体。采用反向计算方法来获得历史患病率和发病率估计值。
2014年引入直接作用抗病毒治疗后，在2015年至2018年期间，所有出生队列的CHC平均患病率从1.23%（95%CI：0.97%-1.5%）下降了约6.5%，至1.15%（95%CI：0.91%-1.45%）。同期，1945年至1965年出生队列和1965年后出生队列也呈现类似趋势。同样，所有出生队列中未诊断CHC感染的平均比例在同一时期从39.36%（95%CI：30.08%-48.48%）下降了约8.25%，至36.36%（95%CI：27.49%-45.31%）。所有三个出生队列均出现类似趋势。
这是第一项利用省级卫生行政数据估计艾伯塔省CHC患病率和未诊断比例的研究。这些结果可为指导当前和未来丙型肝炎病毒策略的决策提供重要证据，并有助于实现世界卫生组织到203０年在加拿大消除丙型肝炎的目标。
