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Volume 17
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10.3390/v17091163
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

The Impact of COVID-19 and Related Public Health Measures on Hepatitis C Testing in Ontario, Canada

by
Yeva Sahakyan
1,
Samantha S. M. Drover
2,
Zoë R. Greenwald
2,3,
William W. L. Wong
4,
Alexander Kopp
2,
Richard L. Morrow
5,6,
Naveed Z. Janjua
5,6 and
Beate Sander
1,2,7,8,*
1
Health Systems and Policy Research Collaborative Centre, University Health Network, Toronto, ON M5G 2C4, Canada
2
ICES, Toronto, ON M4N 3M5, Canada
3
Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
4
School of Pharmacy, University of Waterloo, Kitchener, ON N2G 1C5, Canada
5
British Columbia Centre for Disease Control (BCCDC), Vancouver, BC V5Z 4R4, Canada
6
School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
7
Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
8
Public Health Ontario, Toronto, ON M5G 1M1, Canada
*
Author to whom correspondence should be addressed.
Viruses 2025, 17(9), 1163; https://doi.org/10.3390/v17091163
Submission received: 15 July 2025 / Revised: 21 August 2025 / Accepted: 23 August 2025 / Published: 26 August 2025
(This article belongs to the Section Coronaviruses)
Review Reports Versions Notes

Abstract

The COVID-19 pandemic disrupted progress towards global HCV elimination goals by interrupting essential health services in Canada and globally. We aimed to evaluate the effect of the pandemic on hepatitis C virus (HCV) testing rates in a population-based cohort study in Ontario using health administrative data. All residents with records of either HCV antibody or ribonucleic acid (RNA) tests were included. Monthly testing rate per 1000 population were compared during the pre-pandemic (01/01/2015–29/02/2020) and pandemic (01/03/2020–31/12/2022) periods using interrupted time series models, stratified by sex, homelessness, human immunodeficiency virus (HIV), and immigration status, and people who inject drugs (PWID). The HCV testing rate followed a statistically significant upward trend before the pandemic, dropping at its onset with 1.38/1000 fewer individuals initiating testing monthly. Compared to counterfactual estimates, the observed monthly number of people tested per 1000 population was lower by 1.41 (95% CI: 1.18–1.64) in 2020 (May–Dec), 1.17 (95% CI: 0.99–1.36) in 2021, and 1.41 (95% CI: 1.22–1.59) in 2022, corresponding to relative reductions of 47%, 34%, and 41%, respectively. Testing rates remained below expected levels across all subgroups throughout 2020–2022, with the greatest absolute declines observed among people co-infected with HIV, people experiencing homelessness, and PWID. Tailored, equity-focused interventions are needed to address these persistent gaps in HCV testing, without which Canada’s progress toward its 2030 elimination targets remains at risk.
Keywords: hepatitis C; COVID-19; population-based cohort; administrative data; priority populations; interrupted time series hepatitis C; COVID-19; population-based cohort; administrative data; priority populations; interrupted time series

Share and Cite

MDPI and ACS Style

Sahakyan, Y.; Drover, S.S.M.; Greenwald, Z.R.; Wong, W.W.L.; Kopp, A.; Morrow, R.L.; Janjua, N.Z.; Sander, B. The Impact of COVID-19 and Related Public Health Measures on Hepatitis C Testing in Ontario, Canada. Viruses 2025, 17, 1163. https://doi.org/10.3390/v17091163

AMA Style

Sahakyan Y, Drover SSM, Greenwald ZR, Wong WWL, Kopp A, Morrow RL, Janjua NZ, Sander B. The Impact of COVID-19 and Related Public Health Measures on Hepatitis C Testing in Ontario, Canada. Viruses. 2025; 17(9):1163. https://doi.org/10.3390/v17091163

Chicago/Turabian Style

Sahakyan, Yeva, Samantha S. M. Drover, Zoë R. Greenwald, William W. L. Wong, Alexander Kopp, Richard L. Morrow, Naveed Z. Janjua, and Beate Sander. 2025. "The Impact of COVID-19 and Related Public Health Measures on Hepatitis C Testing in Ontario, Canada" Viruses 17, no. 9: 1163. https://doi.org/10.3390/v17091163

APA Style

Sahakyan, Y., Drover, S. S. M., Greenwald, Z. R., Wong, W. W. L., Kopp, A., Morrow, R. L., Janjua, N. Z., & Sander, B. (2025). The Impact of COVID-19 and Related Public Health Measures on Hepatitis C Testing in Ontario, Canada. Viruses, 17(9), 1163. https://doi.org/10.3390/v17091163

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