Background: We sought to compare rates and factors associated with direct acting antiviral (DAA) treatment uptake and sustained virological response (SVR) between Canadian-born and foreign-born patients. Methods: The study was conducted utilizing a retrospective cohort of hepatitis C virus (HCV)-infected patients assessed at The Ottawa Hospital Viral Hepatitis Clinic between January 2015 and October 2021. Risk factors, income, and clinical characteristics of HCV infection associated with DAA therapy uptake and SVR were compared by immigration status using logistic regression. Results: Of 1,459 HCV-infected patients, 264 (18.1%) were born outside of the country. A median 17 years passed from immigration to first assessment at the clinic. The proportion of patients initiating DAA therapy was similar between groups (65.2% versus 69.5%, p = 0.17). Characteristics associated with DAA therapy uptake included age at first assessment (OR 1.02; 95% CI 1.01 to 1.03) and being cirrhotic (OR 3.19; 95% CI 1.99 to 2.13). Crude SVR rate was higher in immigrants than in Canadian-born patients (91.5% versus 83.7%, p = 0.01). After controlling for other variables, only advancing age was associated with the likelihood of achieving crude SVR (OR 1.04, 95% CI 1.02 to 1.05). Conclusions: We found that DAA therapy uptake and HCV cure rates were high in both groups suggesting equity of opportunity in those referred to our program. The older age at presentation suggests missed opportunities to diagnose and engage immigrants in HCV care. These findings emphasize the importance of early large-scale screening and engagement in care for HCV infection of immigrant populations to prevent future complications.
Background: We sought to compare rates and factors associated with direct acting antiviral (DAA) treatment uptake and sustained virological response (SVR) between Canadian-born and foreign-born patients. Methods: The study was conducted utilizing a retrospective cohort of hepatitis C virus (HCV)-infected patients assessed at The Ottawa Hospital Viral Hepatitis Clinic between January 2015 and October 2021. Risk factors, income, and clinical characteristics of HCV infection associated with DAA therapy uptake and SVR were compared by immigration status using logistic regression. Results: Of 1,459 HCV-infected patients, 264 (18.1%) were born outside of the country. A median 17 years passed from immigration to first assessment at the clinic. The proportion of patients initiating DAA therapy was similar between groups (65.2% versus 69.5%, p = 0.17). Characteristics associated with DAA therapy uptake included age at first assessment (OR 1.02; 95% CI 1.01 to 1.03) and being cirrhotic (OR 3.19; 95% CI 1.99 to 2.13). Crude SVR rate was higher in immigrants than in Canadian-born patients (91.5% versus 83.7%, p = 0.01). After controlling for other variables, only advancing age was associated with the likelihood of achieving crude SVR (OR 1.04, 95% CI 1.02 to 1.05). Conclusions: We found that DAA therapy uptake and HCV cure rates were high in both groups suggesting equity of opportunity in those referred to our program. The older age at presentation suggests missed opportunities to diagnose and engage immigrants in HCV care. These findings emphasize the importance of early large-scale screening and engagement in care for HCV infection of immigrant populations to prevent future complications.
Authors: Jules L Dienstag; Marc G Ghany; Timothy R Morgan; Adrian M Di Bisceglie; Herbert L Bonkovsky; Hae-Young Kim; Leonard B Seeff; Gyongyi Szabo; Elizabeth C Wright; Richard K Sterling; Gregory T Everson; Karen L Lindsay; William M Lee; Anna S Lok; Chihiro Morishima; Anne M Stoddard; James E Everhart Journal: Hepatology Date: 2011-06-23 Impact factor: 17.425
Authors: Rebecca L Morgan; Brittney Baack; Bryce D Smith; Anthony Yartel; Marc Pitasi; Yngve Falck-Ytter Journal: Ann Intern Med Date: 2013-03-05 Impact factor: 25.391
Authors: Jeffrey C Kwong; Sujitha Ratnasingham; Michael A Campitelli; Nick Daneman; Shelley L Deeks; Douglas G Manuel; Vanessa G Allen; Ahmed M Bayoumi; Aamir Fazil; David N Fisman; Andrea S Gershon; Effie Gournis; E Jenny Heathcote; Frances B Jamieson; Prabhat Jha; Kamran M Khan; Shannon E Majowicz; Tony Mazzulli; Allison J McGeer; Matthew P Muller; Abhishek Raut; Elizabeth Rea; Robert S Remis; Rita Shahin; Alissa J Wright; Brandon Zagorski; Natasha S Crowcroft Journal: PLoS One Date: 2012-09-04 Impact factor: 3.240
Authors: Christina Greenaway; Ann Thu Ma; Lorie A Kloda; Marina Klein; Sonya Cnossen; Guido Schwarzer; Ian Shrier Journal: PLoS One Date: 2015-11-11 Impact factor: 3.240