Grant: Project Grant - PA: Infection and Immunity (Early Career Research Support)

Hepatitis C virus (HCV) is a public health issue that has worsened in recent years, both due to the increases in substance use and COVID-19. If treated early, HCV is curable, and cure can prevent cirrhosis, liver cancer, and liver failure. However, if not caught early it can greatly impact quality of life. HCV is the first ever curable chronic viral infection, and in combination with innovate testing strategies such as point-of-care (POC) testing, diagnosis, and then cure; can majorly change one's health trajectory, as well as prevent ongoing transmission. In 2016, Canada signed onto the World Health Organization to Eliminate HCV by 2030, and recently Ontario was the first of 5 regions to publish their regional Roadmap to Eliminate HCV. This was a 3-year effort that included over 300 consultations, an advisory committee with broad representation, and a core working group. This was published in April 2023, and the next steps to implement these strategies are underway. As a part of the implementation of the Roadmap, the Government of Ontario (GoO) has committed to multiple investments towards elimination. In fact, some of these were implemented by the time of the Roadmap publication. The GoO has also funded two positions to coordinate elimination efforts. These efforts will include multiple interventions in quality improvement of testing algorithms, the rollout of publicly-funded HCV POC testing, education, and training interventions, concentrated regional elimination efforts in Ontario, as well as elimination efforts within the 6 priority populations. Although the interventions are funded, the evaluation on impact is not. This proposal will use Ontario's administrative health data at ICES to determine whether these interventions impact the HCV burden of disease in Ontario, determine whether educational intervention expands testing and treatment, and will use health economic modelling to evaluate cost-effectiveness and which interventions need to be added or scaled.