Impact of the COVID-19 Pandemic and Public Health Measures on Hepatitis C Treatment Initiation in Ontario, Canada.
8 affiliations
- 1Health Systems and Policy Research Collaborative Centre, University Health Network, Toronto, ON M5G 2C4, Canada.
- 2ICES, Toronto, ON M4N 3M5, Canada.
- 3School of Pharmacy, University of Waterloo, Kitchener, ON N2G 1C5, Canada.
- 4Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada.
- 5British Columbia Centre for Disease Control (BCCDC), Vancouver, BC V5Z 4R4, Canada.
- 6School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
- 7Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada.
- 8Public Health Ontario, Toronto, ON M5G 1M1, Canada.
Abstract
The impact of the COVID-19 pandemic and related public health measures on hepatitis C (HCV) treatment uptake in Ontario remains uncertain. We evaluated changes in HCV treatment initiation during the pandemic overall and among priority populations. We conducted a population-based study using Ontario health administrative data from January 2015 to December 2022. The primary outcome was HCV treatment initiation rate, defined as the first antiviral dispensation per 1000 eligible individuals. Interrupted time series analysis estimated changes during the pandemic relative to counterfactual projections based on pre-pandemic trends. We stratified analyses by birth cohort, immigration status, homelessness, people who inject drugs (PWID), and human immunodeficiency virus status. A sensitivity analysis restricted the pre-pandemic period to 2018 onward. Among 63,691 eligible individuals, treatment initiation increased from 2015, peaked in 2017, and declined thereafter, resulting in a flat pre-pandemic trend. Treatment initiation declined at pandemic onset and continued downward through 2022; however, neither level nor slope changes were statistically significant. Results were sensitive to pre-pandemic period specification: restricting analyses to 2018 onward showed a significant pre-pandemic decline, with observed pandemic-period rates exceeding counterfactual projections. Younger cohorts, PWID, and individuals experiencing homelessness showed heterogeneous trends. We found no clear evidence that the COVID-19 pandemic independently altered HCV treatment initiation trends in Ontario, although treatment initiation declined at pandemic onset and remained lower throughout the pandemic period.
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BibTeX
@article{sahakyan2026impact,
title = {{Impact of the COVID-19 Pandemic and Public Health Measures on Hepatitis C Treatment Initiation in Ontario, Canada.}},
author = {Yeva Sahakyan and Samantha S M Drover and William W L Wong and Zoë R Greenwald and Alexander Kopp and Richard L Morrow and Naveed Z Janjua and Beate Sander},
journal = {Viruses},
year = {2026},
month = oct,
doi = {10.3390/v18101090},
url = {https://europepmc.org/article/MED/42944010},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of the COVID-19 Pandemic and Public Health Measures on Hepatitis C Treatment Initiation in Ontario, Canada.
AU - Yeva Sahakyan
AU - Samantha S M Drover
AU - William W L Wong
AU - Zoë R Greenwald
AU - Alexander Kopp
AU - Richard L Morrow
AU - Naveed Z Janjua
AU - Beate Sander
PY - 2026
DA - 2026/10/02
JO - Viruses
DO - 10.3390/v18101090
UR - https://europepmc.org/article/MED/42944010
AB - The impact of the COVID-19 pandemic and related public health measures on hepatitis C (HCV) treatment uptake in Ontario remains uncertain. We evaluated changes in HCV treatment initiation during the pandemic overall and among priority populations. We conducted a population-based study using Ontario health administrative data from January 2015 to December 2022. The primary outcome was HCV treatment initiation rate, defined as the first antiviral dispensation per 1000 eligible individuals. Interrupted time series analysis estimated changes during the pandemic relative to counterfactual projections based on pre-pandemic trends. We stratified analyses by birth cohort, immigration status, homelessness, people who inject drugs (PWID), and human immunodeficiency virus status. A sensitivity analysis restricted the pre-pandemic period to 2018 onward. Among 63,691 eligible individuals, treatment initiation increased from 2015, peaked in 2017, and declined thereafter, resulting in a flat pre-pandemic trend. Treatment initiation declined at pandemic onset and continued downward through 2022; however, neither level nor slope changes were statistically significant. Results were sensitive to pre-pandemic period specification: restricting analyses to 2018 onward showed a significant pre-pandemic decline, with observed pandemic-period rates exceeding counterfactual projections. Younger cohorts, PWID, and individuals experiencing homelessness showed heterogeneous trends. We found no clear evidence that the COVID-19 pandemic independently altered HCV treatment initiation trends in Ontario, although treatment initiation declined at pandemic onset and remained lower throughout the pandemic period.
SN - 1999-4915
ER -