Grant: Doctoral: Vanier Canada Graduate Scholarships

Hepatitis C (HCV) is a virus that spreads through blood contact. Without treatment, HCV can cause severe liver damage. Disadvantaged populations in Alberta (lower-income people, those who inject drugs, and people in prison) are less likely to meet with a special hepatitis doctor, be given treatment, and be cured of HCV. Additionally, fewer women are tested and treated for HCV compared to men. This finding is concerning for pregnant persons because HCV can pass from mom to baby during pregnancy. We propose three methods to improve the testing and linkage to care for disadvantaged and pregnant patients infected with HCV in Alberta. First, we will use HCV reflex testing in our laboratories, which only requires a single blood sample from a patient (previously we required two blood samples). I will determine the benefits of HCV reflex testing for disadvantaged populations by comparing the number of patients referred to a hepatitis doctor, prescribed treatment, and cured of the virus for two years before and after using reflex testing. Next, we will test all pregnant persons for HCV during their prenatal panel in the first trimester. I will evaluate the number of HCV positive pregnant persons over a two-year period and compare to the number of HCV positives (tested based on risk) before our program. I will also determine the program's affordability for the province. Finally, we will use phone calls to help directly link all pregnant positives to hepatitis doctors for follow-up. I will assess if direct linkage is effective by comparing the number of patients that see a specialist, are prescribed treatment, and cured of HCV to those indirectly linked to specialists over a two-year period. We expect our programs to improve health outcomes for disadvantaged and pregnant patients infected with HCV and reform health policies in Alberta. If effective, these programs could be used in other provinces and territories across Canada.