Grant: Operating Grant - Priority Announcement : Hepatitis C (bridge)

HIV- Hepatitis C (HCV) co-infection is a growing concern across Canada. Evidence suggests that co-infected individuals advance faster to endstage liver disease (ESLD) compared to HCV mono-infected patients. Effective combination antiretroviral therapy has lead to a significant decline in deaths and from nearly all illnesses in HIV+ individuals, except for liver disease. One way to reduce liver related illness and death is to cure HCV infection. However for years, the standard of care for HCV treatment resulted in low success rates and had serious side effects lasting up to 48 weeks. With research advancements, there are now excellent medications to treat HCV. But these medications are very expensive and don't work equally for all. Important questions need to be addressed such as what are the best strategies to treat those most in need and who will most benefit from treatment? The Canadian Co-infection Cohort (CCC) is in a unique position to investigate the impact of these new drugs in the setting of HIV-HCV co-infection. The CCC is comprised of 1248 participants from 18 centres across Canada. Detailed information on social characteristics, drug/alcohol use, disease status and treatments have been collected over the last 10 years and now we will expand to study new HCV treatments. We will describe different models of care (how to engage and successfully treat the most vulnerable). We will determine which patients get treated and their success rates. Then, by linking that information with provincial administrative databases we will study how treatment can improve health and reduce health care use (ex. ER visits, hospital and doctors visits) to determine if there are health economic benefits of new HCV therapies. We are in an era of new challenges, cures for HCV will be available but will everyone really benefit from treatment? We hope that the results from this proposal will answer that specific question and help bring an end to the HCV epidemic in Canada.