The 5th Canadian Symposium on Hepatitis C Virus: We Are Not Done Yet—Remaining Challenges in Hepatitis C

Buuren, Nicholas van; Fradette, Lorraine; Grebely, Jason; King, Alexandra; Krajden, Mel; MacParland, Sonya A.; Marshall, Alison D.; Saeed, Sahar; Wilson, Joyce A.; Klein, Marina B.; Sagan, Selena M.

doi:10.1155/2016/7603526

Cited by 8 publications

(3 citation statements)

References 29 publications

(38 reference statements)

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“…16,24,26 Physician factors included guidelines for treatment which included moderate to severe fibrosis (!F2), anticipation for arrival of newer DAA especially as from 2014 thereby deferring treatment to await new HCV therapies. 24,27 Our treatment outcomes (SVR) were comparable with those published in trials of patients treated with peg IFN/ ribavirin (82.14% of patients with genotype 2, 41.9% genotype 1 and 36.3% genotype 4 achieved SVR). 28,29 Experience on this treatment and its outcome is sparse in this sub-region.…”

Section: Discussionsupporting

confidence: 78%

Hepatitis C Continuum of Care in a Treatment Center in Sub-Saharan Africa

Luma

Eloumou

Noah

et al. 2018

Journal of Clinical and Experimental Hepatology

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Background: Hepatitis C virus (HCV) infection is a major public health challenge in Cameroon with over three million people infected. Government efforts to improve care and treatment are unsatisfactory and need to be assessed. We aimed at studying the several steps along the HCV continuum of care in one of two hepatitis treatment centers in Cameroon. Methods: We undertook a retrospective chart review of anti-HCV positive individuals, who attended the Douala general hospital between 2008 and 2015. We defined the HCV treatment cascade as follows: step 1-HCV RNA testing, step 2-complete pre-therapeutic evaluation (genotyping and liver fibrosis markers), step 3-initiation of treatment, step 4-treatment completion, and step 5-sustained virological response (SRV). Each successive step in the HCV care continuum was dependent on passing through the previous step. Results: The mean age of the 669 anti-HCV antibody positive individuals was 57 (sd: AE13) years. Females were 52.8% of the study population. 410 (61.3%) were tested for HCV RNA. Three hundred and sixty-six (54.7%) were confirmed to have viral replication (HCV RNA positive). One hundred and eighty (26.9%) did a complete pre-therapeutic evaluation (both HCV genotyping and liver fibrosis assessment included). Eighty-one (12.1%) initiated treatment with pegylated interferon/ribavirin. Seventy-two (10.8%) completed treatment and 44 (6.6%) had SVR. Sociodemographic characteristics including age, gender, marital status, having medical insurance, and profession were associated with attaining later steps in the care cascade. Conclusion: This study shows that HCV continuum of care and treatment is less optimal at the Douala general hospital and is highly impacted by socioeconomic factors. Continued efforts are needed to improve HCV care.

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Section: Discussionsupporting

confidence: 78%

Hepatitis C Continuum of Care in a Treatment Center in Sub-Saharan Africa

Luma

Eloumou

Noah

et al. 2018

Journal of Clinical and Experimental Hepatology

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“…The NCRTP-HepC and subsequently CanHepC has brought together HCV researchers and community members via the past eight annual symposia (6)(7)(8)(9)(10)(11). The 9th CSHCV was held on February 28, 2020, in Montreal, Quebec, as a joint conference with the annual Canadian Liver Meeting.…”

Section: Th Cshcvmentioning

confidence: 99%

The 9th Canadian Symposium on Hepatitis C Virus: Advances in HCV research and treatment towards elimination

Casey

Greenwald

et al. 2021

CanLivJ

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Hepatitis C virus (HCV) elimination has evolved into a coordinated global effort. Canada, with more than 250,000 chronically infected individuals, is among the countries leading this effort. The 9th Canadian Symposium on HCV, held in February 2020, thus established and addressed its theme, ‘advances in HCV research and treatment towards elimination’, by gathering together basic scientists, clinicians, epidemiologists, social scientists, and community members interested in HCV research in Canada. Plenary sessions showcased topical research from prominent international and national researchers, complemented by select abstract presentations. This event was hosted by the Canadian Network on Hepatitis C (CanHepC), with support from the Public Health Agency of Canada and the Canadian Institutes of Health Research and in partnership with the Canadian Liver Meeting. CanHepC has an established record in HCV research by its members and in its advocacy activities to address the care, treatment, diagnosis, and immediate and long-term needs of those affected by HCV infection. Many challenges remain in tackling chronic HCV infection, such as the need for a vaccine; difficult-to-treat populations and unknown aspects of patient subgroups, including pregnant women and children; vulnerable people; and issues distinct to Indigenous peoples. There is also increasing concern about long-term clinical outcomes after successful treatment, with the rise in comorbidities such as diabetes, cardiovascular disease, and fatty liver disease and the remaining risk for hepatocellular carcinoma in cirrhotic individuals. The symposium addressed these topics in highlighting research advances that will collectively play an important role in eliminating HCV and minimizing subsequent health challenges.

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“…Interferon-free direct-acting antiviral (DAA) treatments have dramatically increased the likelihood of cure of, and reduced treatment length for, hepatitis C virus (HCV); improved the side effects profile of treatment; and facilitated eligibility for and delivery of treatment to those living with HCV (1,2). Yet HCV remains one of the most burdensome infections in Canada (3,4), with an estimated 250,000 Canadians infected in 2013 (5) and an estimated diagnosed infection incidence rate of 31.06 per 100,000 in 2016 (6). HCV is responsible for more years of life lost than any other infectious disease in Canada (5).…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional study of prolonged disengagement from clinic among people with HCV receiving care in a low-threshold, multidisciplinary clinic

Kendall

Fitzgerald

Donelle³

et al. 2020

CanLivJ

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BACKGROUND: Disengagement from care can affect treatment outcomes of patients with hepatitis C virus (HCV). We assessed the extent and determinants of disengagement among HCV patients receiving care at the Ottawa Hospital Viral Hepatitis Program (TOHVHP). METHODS: We linked clinical data of adult patients, categorized as ever or never disengaged from clinic (no TOHVHP encounters over 18 months), receiving care between April 1, 2002, and October 1, 2015, to provincial health administrative databases and calculated primary care use in the year after disengagement. We used adjusted Cox proportional hazards models to analyze variables associated with disengagement. RESULTS: Those disengaged from care (n = 657) were younger at presentation (46.6 [SD 11.1] versus 51.9 [SD 11.0] years), p < 0.001) and had lower comorbidity. After multivariable adjustment, we observed lower hazards of disengagement among those with higher compared with lower fibrosis scores (F3, hazard ratio [HR] 0.21 [95% CI 0.08-0.57]; F4, HR 0.32 [95% CI 0.19-0.55]) and those treated compared with never treated (received direct-acting antivirals [DAAs], HR 0.71 [95% CI 0.58-0.88]; received interferon but not DAA, HR 0.66 [95% CI 0.55-0.80]). We found no association with mental health or substance use disorders. In the year after disengagement, 74.3% (n = 488), 37.1% (n = 244), and 17.7% (n = 116) had at least one family physician visit, emergency department visit, and hospitalization, respectively. CONCLUSIONS: Better integration of HCV specialty and primary care could improve disengagement rates among people with HCV.

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The 5th Canadian Symposium on Hepatitis C Virus: We Are Not Done Yet—Remaining Challenges in Hepatitis C

Cited by 8 publications

References 29 publications

Hepatitis C Continuum of Care in a Treatment Center in Sub-Saharan Africa

Hepatitis C Continuum of Care in a Treatment Center in Sub-Saharan Africa

The 9th Canadian Symposium on Hepatitis C Virus: Advances in HCV research and treatment towards elimination

A cross-sectional study of prolonged disengagement from clinic among people with HCV receiving care in a low-threshold, multidisciplinary clinic

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