Utilizing a syndemic approach for population level prevention, care and treatment cascades of hepatitis C virus and related epidemics

Different distributions of social conditions, vulnerabilities, (e.g. drug use, mental illness) or other infections (HIV, HBV, TB), contribute to differences among populations affected by hepatitis C virus (HCV) infection. The different distribution of these comorbidities drives differences in cascades of care (diagnosis, initiation of treatment, cure and retention in care).

This study aims to improve HCV treatment and prevention by applying concepts of syndemic theory (how co-occuring conditions interact) to improve the integration and delivery of health services among populations affected by HCV infection, such as people born 1945-65 (“Baby Boomers”) and people who inject drugs (PWID). Using the British Columbia Hepatitis Testers Cohort (BC-HTC), which includes all individuals tested for HCV, HIV, HBV, sexually transmitted infections or TB since 1990, linked with administrative and healthcare data, the study will extend the HCV cascade of care to include prevention and care related to underlying syndemic factors (e.g. drug use, mental illness and other co-infections).

Identifying and investigating gaps in HCV care cascades, and syndemic factors associated with these gaps, will help identify avenues for shared and integrated interventions to improve prevention and care for HCV, and underlying substance use.

End of award update: December 2021

Following the end of her award term, Dr. Bartlett has provided the following brief update on this project’s progress.

Key impacts arising from fellowship program of work

Impact goal:
Help BC Centre for Disease Control analyze whether their investment in expensive hepatitis C medications are worthwhile.

Impact summary:
Dr. Bartlett’s research evaluated the impact of introducing new medications, called Direct Acting Antivirals (DAAs) used for treating HCV infection. It led to the only HCV care cascade in Canada in the DAA era and provided crucial data that can help drive policy changes aimed at eliminating HCV across the country. It also showed how useful linked administrative health data platforms are to improving the surveillance and monitoring of infections and chronic diseases, such as HCV.

Read more about the impact of Dr. Bartlett’s fellowship in the CIHR HSIF 2017-19 Embedded Research Impact Casebook.