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ontario falling behind on targets to eliminate hepatitis c: report

manitoba and québec are also lagging in testing and treatments, a fix that would save 170 lives, according to a recent study in the canadian liver journal.

by emma jones

published dec 01, 2022

last updated feb 16, 2023

3 minute read

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3 minute read

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hepatitis c can be transmitted unknowingly

hepatitis c is a blood-borne virus that attacks the liver. getty

ontario, manitoba and quebec are falling behind in canada’s goal to eliminate viral hepatitis c by 2030. canada is a signatory of the 2016-2021 global viral hepatitis strategy, which sets “a goal of eliminating viral hepatitis as a major public health threat by 2030.” elimination objectives are defined as reducing chronic hepatitis c infections by 80 per cent, reducing mortality from the virus by 65 per cent, and achieving 90 per cent diagnosis coverage and 80 per cent treatment coverage.

because health care is administered by the provincial governments, these goals are measured on a province-by-province basis. and while most provinces are on-track, a recent study published in the canadian liver journal warns two of canada’s most populous provinces are falling behind.

“the pandemic has definitely affected our ability to address hepatitis c,” says dr. jordan feld, senior scientist at toronto general hospital research institute and lead author on the paper. “we’ve seen more infections because of increasing injection drug use and less access to harm reduction services, less access to people getting the care that they need.

“we’ve definitely seen a drop off in the number of people getting diagnosed, and then the number of people starting and completing treatment.”

getting manitoba, ontario, and québec back on track would save 170 lives, the report estimates. it would also save the provinces $122.6 million in direct medical costs, but would require 540, 7,700, and 2,800 annual treatments, respectively.

“the ministry of health funds 18 multidisciplinary hepatitis c care and treatment teams located in community and health organizations across ontario,” reads a statement provided by the ontario ministry of health. “these teams work with people who are at highest risk of acquiring hepatitis c and who face systemic barriers to accessing mainstream health and social services.

“ontarians can also access hepatitis c testing, care and treatment through primary care, hospital and community-based specialists and other health care models, such as ontario health teams.”

feld adds the teams set up to eliminate hepatitis c are working hard to reach remote and marginalized communities, key to reaching these goals. as the liver is also fairly resilient, once a patient gets access to treatment for viral hepatitis c, the prognosis is often quite good.

why is ontario having trouble reaching hepatitis elimination goals?

hepatitis c may not cause symptoms for years, meaning unknown transmission of the virus is one of the greatest threats to elimination targets.

in 2019, the canadian government released the five-year action plan on sexually transmitted and blood-borne infections (stbbis). key to addressing stbbis in canada — including viral hepatitis — is to remove barriers to testing, according to the five-year action plan. but because so many communities in canada are remote, transporting blood samples to testing laboratories is often unfeasible.

other barriers, like fear of stigma and concerns around confidentiality also make it difficult to create a robust prevention and treatment protocol in many communities.

feld says in a large, populous province like ontario, having the resources to support programs already in play is a critical issue. the pandemic showed canada has the ability to develop responsive and far-reaching testing and treatment centres. why not use some of the lesson and infratructure from the pandemic to address other conditions?

“if we could use some of the tools that were developed for [the pandemic], if we could use some of the testing capacity that was built up in the public health laboratory to test for covid, if we could use some of the public health approaches that were used to reach marginalized populations, to bring testing outside of health care institutions and into the community, those things would all really benefit patients for hepatitis c, just as they did for covid,” says feld.

solutions already at play include outreach teams which work across the province to engage marginalized and remote populations. new dried blood spot (dbs) technology, driven by canada’s national microbiology laboratory, also allows dried blood to be mailed to the nearest laboratory for stbbi testing — useful for remote locations.

ontario’s ministry of health did not respond to multiple requests for comment.

emma jones is a multimedia editor with healthing. you can reach her at emjones@postmedia.com or on instagram and twitter @jonesyjourn.

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ontario falling behind on targets to eliminate hepatitis c: report

manitoba and québec are also lagging in testing and treatments, a fix that would save 170 lives, according to a recent study in the canadian liver journal.

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why is ontario having trouble reaching hepatitis elimination goals?

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