Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan 23;13(1):e0191184.
doi: 10.1371/journal.pone.0191184. eCollection 2018.

Population-based estimate of hepatitis C virus prevalence in Ontario, Canada

Shelly Bolotin  1   2 , Jordan J Feld  3   4 , Gary Garber  1   5 , William W L Wong  6 , Fiona M Guerra  1 , Tony Mazzulli  1   7
Affiliations

Population-based estimate of hepatitis C virus prevalence in Ontario, Canada

Shelly Bolotin et al. PLoS One. .

Abstract

Background: Hepatitis C virus (HCV) is the most burdensome infectious illness in Canada. Current screening strategies miss a significant proportion of cases, leaving many undiagnosed. Elevated HCV prevalence in those born between 1945 and 1965 has prompted calls for birth-cohort screening in this group. However, Canada lacks population-level data to support this recommendation. We performed a serosurvey to obtain population-based HCV prevalence estimates in Ontario residents born between 1945-1974, to generate evidence for birth-cohort screening recommendations.

Methods: We tested anonymized residual sera in five-year age-sex bands from Ontario for anti-HCV antibody. We performed descriptive epidemiological analysis and used a logistic regression model to determine HCV risk-factors.

Results: Of 10,006 sera analyzed, 155 (1.55%, 95% confidence interval (CI) 1.32, 1.81) were positive for HCV antibody. Individuals born between 1950-1964 had a significantly higher combined prevalence of 1.92% (95% CI 1.56, 2.34) compared to 1.14% (95% CI 0.69, 1.77) (p = 0.04) for those born between 1970-1974. For males, comprising 107/155 (69.03%) of positive samples, the highest prevalence was 3.00% (95% CI 1.95, 4.39) for the 1960-1964 birth-cohort. For females, the highest prevalence was 1.56% (95% CI 0.83, 2.65) for those born between 1955-1959. Male sex was significantly associated with positive HCV serostatus.

Interpretation: HCV prevalence in Ontario is highest among those in this birth cohort, and higher than previous estimates. The prevalence estimates presented in our study provide important data to underpin birth-cohort screening recommendations.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: JJF reports receiving funds for scientific consulting and/or research support from Abbvie, BMS, Gilead, Janssen and Merck. GG has received research support from Gilead, AbbVie, Pfizer, Merck and Janssen. TM is an advisory board member of Roche Diagnostics, Abbott Laboratories, Merck, Paladin, Pfizer, Microbix, bioMerieux, and Qvella. He has received research funding from Qvella, Luminex, and altona diagnostics, and funds for honoraria/scientific consulting from Merck, Abbott, Microbix, and Paladin. WWLW has received research support from the Canadian Liver foundation. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Ontario public health units and health unit regions.
Fig 2
Fig 2. HCV antibody prevalence, by birth cohort year-band and sex.
See this image and copyright information in PMC

References

    1. World Health Organization (WHO). Hepatitis C Fact sheet. July 2016.
    1. Trubnikov M, Yan P, Archibald C. Estimated prevalence of Hepatitis C Virus infection in Canada, 2011. CCDR. 2014;40: 429–436. - PMC - PubMed
    1. Kwong JC, Ratnasingham S, Campitelli MA, Daneman N, Deeks SL, Manuel DG, et al. The impact of infection on population health: results of the Ontario burden of infectious diseases study. PLoS One. 2012;7: e44103 doi: 10.1371/journal.pone.0044103 - DOI - PMC - PubMed
    1. Webster DP, Klenerman P, Dusheiko GM. Hepatitis C. Lancet. 2015;385: 1124–1135. doi: 10.1016/S0140-6736(14)62401-6 - DOI - PMC - PubMed
    1. Ontario Agency for Health Protection and Promotion (Public Health Ontario), Provincial Infectious Diseases Advisory Committee. Recommendations for the public health response to hepatitis C in Ontario. 2014.

Publication types

Substances