Impact of COVID-19-related public health measures on HCV testing in British Columbia, Canada: an interrupted time series analysis.

Binka, Mawuena; Bartlett, Sofia; Velásquez García, Héctor Alexander; Darvishian, Maryam; Jeong, Dahn; Adu, Prince; Alvarez, Maria; Wong, Stanley; Yu, Amanda; Samji, Hasina; Krajden, Mel; Wong, Jason; Janjua, Naveed Zafar

BACKGROUND & AIMS Public health measures introduced to limit transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), also disrupted various healthcare services in many regions worldwide, including British Columbia (BC), Canada. We assessed the impact of these measures, first introduced in BC in March 2020, on hepatitis C (HCV) testing and first-time HCV-positive diagnoses within the province. METHODS De-identified HCV testing data for BC residents were obtained from the provincial Public Health Laboratory. Weekly changes in anti-HCV, HCV RNA, and genotype testing episodes and first-time HCV-positive (anti-HCV/RNA/genotype) diagnoses from January 2018 to December 2020 were assessed and associations determined using segmented regression models examining rates before versus after calendar week 12 of 2020, when measures were introduced. RESULTS Average weekly HCV testing and first-time HCV-positive diagnosis rates fell immediately following the imposition of public health measures by 62.3 per 100,000 population and 2.9 episodes per 1,000,000 population, respectively (p<0.0001 for both), and recovered in subsequent weeks to near pre-March 2020 levels. Average weekly anti-HCV positivity rates decreased steadily pre-restrictions and this trend remained unchanged afterwards. CONCLUSIONS Reductions in HCV testing and first-time HCV-positive diagnosis rates, key drivers of progression along the HCV care cascade, occurred following the introduction of COVID-19-related public health measures. Further assessment will be required to better understand the full impact of these service disruptions on the HCV care cascade and to inform strategies for the re-engagement of people who may have been lost to care because of these measures.