Responding to the dual epidemics of hepatitis C and addiction in British Columbia

In British Columbia (BC), it is estimated that 78,000 people are living with hepatitis C virus (HCV), most of whom do not even know they have the disease. If left untreated, HCV can cause serious harm, including liver cancer and death. People who inject drugs (PWID) are at elevated risk of HCV infection given their exposure to various individual and environmental circumstances, such as their ongoing addiction and barriers to accessing health care. A growing body of research suggests that harm reduction and addiction treatment programs may present important opportunities to engage PWID in the HCV treatment and care. Efforts are now underway in BC to dramatically expand access to low-threshold addiction treatment that extends beyond traditional methods. Research in this area is particularly timely, as these new policies offer an opportunity to evaluate the impacts of the expansion and optimization of addiction treatment on HCV-related outcomes among PWID.

Dr. Ti's research is an extension of past work that focused on the relationships between infectious diseases, addiction, and the delivery of harm reduction and health services. Utilizing her expertise in this area, Ti will evaluate novel interventions to reduce the health burden caused by HCV and addiction by:

• Characterizing HCV re-infection rates among PWID and examining harm reduction-based and addiction treatment interventions that may protect against reinfection.
• Evaluating evolving addiction treatment guidelines and their impact on HCV incidence among PWID.
• Evaluating the impact of innovative HCV and addiction treatment interventions on treatment uptake and completion.

This research is designed to provide evidence for health system leaders and policy makers to develop policies that are in line with evolving trends in HCV and addiction, and to support health system improvement.