Grant: Operating Grant

Hepatitis C virus (HCV) infection is a global public health threat with an estimated prevalence of 3%, representing 170 million people. It is associated with progressive liver damage that can lead to scarring (cirrhosis), liver failure and cancer. Viral hepatitis, liver cancer and liver-related death are all on the rise, suggesting that the costs of care will continue to increase without adequate prevention and treatment. People with chronic HCV have increased liver disease progression if they are co-infected with hepatitis B virus (HBV) or HIV. Currently, information at the population-level on the long-term consequences of HCV and co-infection with HBV or HIV is limited in terms of the health and economic burden in Canada. Our objectives are to: (1) examine trends in morbidity and mortality in a population-based cohort of individuals with HCV mono-infection and HCV/(HBV or HIV) co-infection in Ontario (1996-2013); (2) explore trends in net health services utilization and costs of care due to HCV mono-infection and HCV/(HBV or HIV) co-infection, and estimate long-term net costs of care; and (3) evaluate the cost-effectiveness of screening strategies for HCV mono-infection and HCV/(HBV or HIV) co-infection from a healthcare payer's perspective (2002-2013). Population-based cohort studies will be conducted using linked health administrative data for Ontario. Findings from this project will: (1) inform patients, clinicians, public health providers, and policy decision-makers about the burden of disease; (2) enhance knowledge exchange and dissemination to promote uptake of existing evidence-informed interventions that improve the health of the Canadian population and its healthcare system; and (3) provide relevant information for cost-effectiveness analysis of interventions to inform policy decision-makers and health service planners in investing effective prevention programs, that aim to reduce health and economic burden due to HCV and co-infection with HBV or HIV.