The Hepatitis C Cascade of Care among people in the Downtown Eastside in Vancouver, British Columbia: a population-based study

The Hepatitis C virus (HCV) care cascade in British Columbia (BC) revealed gaps in testing, treatment initiation, and key disparities among priority populations. The introduction of Direct Acting Antivirals and policy changes, such as removing liver fibrosis stage as a treatment criterion, improved all stages of the care cascade by 2018 compared to 2012. However, limited data exist on high-priority populations, particularly those with high HCV prevalence and follow-up challenges, such as Vancouver Downtown East-Side (DTES) residents.

This study will assess the updated HCV care cascade in BC among individuals living and accessing services in the DTES, including priority subgroups. It will evaluate cascade steps over time and progress to date. We will engage stakeholders, including provincial/national initiatives and a DTES-focused social service agency, throughout the research process.

We anticipate lower HCV testing and care linkage rates among DTES residents and persistent gaps in high-risk groups.

Findings will inform health services and policies to advance Canada’s goal of eliminating HCV as a public health threat by 2030, reducing mortality, and improving outcomes for vulnerable populations.