Hepatitis C Virus (HCV) Age, Gender and Indigenous Ancestry

Data Collection

Enhanced surveillance data between 2005 and 2012 in the Web-enabled Infectious Disease Surveillance System (WebIDSS) was examined for records with evidence of HCV testing. HCV cases were determined by either a positive serology result (antibody or RNA positive), treated for HCV, or self-reported HCV positive status. Records were reviewed for data quality and consistency. HCV case status was cross tabulated with gender, Indigenous ancestry, and age. Data were extracted June 2016.

Analysis and Results

HCV Cases

A total of 25,655 records with information on HCV status were included in the analysis. Of these, 6,524 records met the definition for HCV case status (25.4%). Of the 6,524 HCV cases, 5,216 (80%) already knew their positive status on admission (1,231, or 24% were newly diagnosed via routine screening at intake). Of the 1,308 inmates newly diagnosed with HCV on follow up during their incarceration, 330 had baseline negative serology data (laboratory confirmed seroconversion)Footnote 1.

HCV Prevalence

Table 1: HCV Prevalence by Gender, Indigenous Ancestry, and Age
  HCV Case Prevalence± ChiSquare
Total
Overall 6524/25,655 (25.4%) n/a
Gender
Male 5926/23,844 (24.9%) p<0.0001
Female 594/1,797 (33.1%)
Indigenous Ancestry
Indigenous 1859/5,847 (31.8%) p<0.0001
Non-Indigenous 4665/19,808 (23.6%)
Age
17-19 8/240 (3.3%) p<0.0001
20-29 973/8,660 (11.2%)
30-39 2120/7,547 (28.1%)
40-49 2307/5,752 (40.1%)
50-59 922/2,470 (37.3%)
60+ 152/800 (19.0%)

±-Numbers may not add due to missing data

HCV prevalence was higher among women offenders (33.1% vs 24.9%), higher among inmates of Indigenous ancestry (31.8% vs 23.6%), and highest among inmates 40-49 years of age (40.1%) (see Table 1).

Indigenous Ancestry and Gender

HCV prevalence was highest among women offenders of Indigenous ancestry (44.8%) compared to male inmates of Indigenous ancestry (30.4%) and other women offenders (27.7%) (see Figure 1).

The bar graph shows the prevalence of HIV and breaks down the information by origin and gender. Non-Indigenous males (shown in blue) represent 1.47% of cases, and non-Indigenous females (shown in pink), 2.16%. Indigenous males (shown again in blue) represent 2.27% of cases, and Indigenous females (shown again in pink), 6.03%.

Gender and Age

Among male inmates, the highest HCV prevalence was observed among 40-49 (40.3%) and 50-59 (37.5%) age groups. Among women offenders, the highest HCV prevalence was observed among 40-49 (38.4%) and 30-39 (38.0%) age groups.

Among male inmates of Indigenous ancestry the highest HCV prevalence was observed among 50-59 (51.1%) and 40-49 (50.9%) age groups. Among women offenders of Indigenous ancestry, the highest HCV prevalence was observed among 50-59 (61.5%) and 40-49 (59.8%) age groups.

Summary

The estimated HCV prevalence of 25.4% among inmates in CSC was consistent with previously published reports using other methodsFootnote 2. Most (80%) of the burden of prevalence is acquired prior to incarceration at CSC. This analysis demonstrates that particular subgroups (women offenders, inmates of Indigenous ancestry), especially older women offenders of Indigenous ancestry are at increased likelihood of having HCV.

Footnotes

Footnote 1

Health Services Quick Facts; HCV Repeat Testing and Seroconversion. CSC 2016

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Footnote 2

Health Services Quick Facts; HCV Surveillance Report 2014. CSC 2016

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