BMC Infectious Diseases
Volume 17, Issue 1, 2017

A population-based study of chronic hepatitis C in immigrants and non-immigrants in Quebec, Canada (Article) (Open Access)

Greenaway C.* , Azoulay L. , Allard R. , Cox J. , Tran V.A. , Abou Chakra C.N. , Steele R. , Klein M.
  • a Jewish General Hospital, McGill University, Division of Infectious Diseases, 3755 Côte St. Catherine Road, Montreal, PQ H3T 1E2, Canada, McGill University, Centre for Clinical Epidemiology, Lady Davis Research Institute for Medical Research, Jewish General Hospital, Montreal, Canada
  • b McGill University, Centre for Clinical Epidemiology, Lady Davis Research Institute for Medical Research, Jewish General Hospital, Montreal, Canada, McGill University, Department of Oncology, Montreal, Canada
  • c McGill University, Department of Oncology, Montreal, Canada, Montreal Public Health Department, Montreal, Canada
  • d Sexually Transmitted Infections Division, Montreal Public Health Department, Montreal, Canada
  • e McGill University, Centre for Clinical Epidemiology, Lady Davis Research Institute for Medical Research, Jewish General Hospital, Montreal, Canada
  • f McGill University, Centre for Clinical Epidemiology, Lady Davis Research Institute for Medical Research, Jewish General Hospital, Montreal, Canada
  • g McGill University, Centre for Clinical Epidemiology, Lady Davis Research Institute for Medical Research, Jewish General Hospital, Montreal, Canada, McGill University, Department of Mathematics and Statistics, Montreal, Canada
  • h McGill University Health Center, McGill University, Division of Infectious Diseases, Montreal, Canada

Abstract

Background: Immigrants originating from intermediate and high HCV prevalence countries may be at increased risk of exposure to hepatitis C infection (HCV) in their countries of origin, however they are not routinely screened after arrival in most low HCV prevalence host countries. We aimed to describe the epidemiology of HCV in immigrants compared to the Canadian born population. Methods: Using the reportable infectious disease database linked to the landed immigration database and several provincial administrative databases, we assembled a cohort of all reported cases of HCV in Quebec, Canada (1998-2008). Underlying co-morbidities were identified in the health services databases. Stratum specific rates of reported cases/100,000, rate ratios (RRs) and trends over the study period were estimated. Results: A total of 20,862 patients with HCV were identified, among whom 1922 (9.2%) were immigrants. Immigrants were older and diagnosed a mean of 9.8 ± 7 years after arrival. The Canadian born population was more likely to have behavior co-morbidities (problematic alcohol or drug use) and HIV co-infection. Immigrants from Sub-Saharan Africa, Asia and Eastern Europe had the highest HCV reported rates with RRs compared to non-immigrants ranging from 1.5 to 1.7. The age and sex adjusted rates decreased by 4.9% per year in non-immigrants but remained unchanged in immigrants. The proportion of HCV occurring in immigrants doubled over the study period from 5 to 11%. Conclusions: Immigrants from intermediate and high HCV prevalence countries are at increased risk for HCV and had a mean delay in diagnosis of almost 10 years after arrival suggesting that they may benefit from targeted HCV screening and earlier linkage to care. © 2017 The Author(s).

Author Keywords

Viral hepatitis Rates Immigrant Incidence Hepatitis C

Index Keywords

rural area immigrant Africa south of the Sahara Human immunodeficiency virus infection mass screening public health service alcohol consumption methodology Research Design Quebec human immigration comorbidity middle aged birthplace Asia statistics and numerical data Health Behavior controlled study data base chronic hepatitis C Hepatitis C, Chronic Aged Eastern Europe epidemiological data Young Adult Sentinel Surveillance Humans migrant Adolescent male Canada Emigrants and Immigrants female Socioeconomic Factors socioeconomics diagnostic test population research Coinfection prevalence Health Knowledge, Attitudes, Practice Article Retrospective Studies major clinical study adult seroepidemiology drug abuse age methadone drug use Endemic Diseases cohort analysis retrospective study Seroepidemiologic Studies sex attitude to health anti human immunodeficiency virus agent mixed infection public health
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85012965411&doi=10.1186%2fs12879-017-2242-y&partnerID=40&md5=814d582ca32da4855e64e9d0dce656c7
DOI: 10.1186/s12879-017-2242-y
ISSN: 14712334
Cited by: 10
Original Language: English