Hepatitis C Treatment Outcomes Among Immigrants: A CANUHC Cohort Analysis
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ID: 322589
2026
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Abstract
Abstract Background Immigrants to Canada are disproportionately affected by HCV infection. Little is known about treatment outcomes among immigrants at the national level or how outcomes vary across Canadian provinces. Methods We used data from the Canadian Network Undertaking against Hepatitis C (CANUHC), a prospective cohort enrolling HCV RNA positive patients from 17 sites across six Canadian provinces between 2015 and 2025. Sociodemographic data, clinical characteristics, immigration details, time to first consult and treatment outcomes were evaluated. Treatment outcomes included DAA initiation, SVR bloodwork completion, and SVR achievement. Results Of 2,521 patients, 427 (16.9%) were immigrants to Canada. Immigrants had higher educational attainment (60.8% vs. 28.2% college/university, p<0.001), higher employment (47.1% vs. 28.0%, p<0.001), and lower proportions with injection drug use history (25.8% vs. 75.3%, p<0.001), incarceration history (12.9% vs. 49.1%, p<0.001), and recreational drug use history (43.5% vs. 91.8%, p<0.001). Immigrants demonstrated excellent DAA treatment outcomes with higher crude rates of DAA initiation (95.6% vs. 92.2%, p=0.02), post-treatment SVR bloodwork completion (81.6% vs. 70.5%, p<0.001), and SVR (100% vs. 98.6%, p=0.03). However, after adjustment for age, sex, race and key socioeconomic measures, immigration status was not independently associated with these outcomes. The mean time from immigration to specialist assessment was 24.9 years (SD 18.6). The delay in accessing care trended downwards with each 5-year interval from 1990 to the present (median years=26, 22, 16, 12, 7, 2, p<0.001). Conclusions Immigrants in the CANUHC cohort achieved excellent DAA treatment outcomes comparable to or exceeding those of Canadian-born patients. When engaged in care, immigrants can successfully complete the HCV treatment cascade.
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| Authors | Haris Imsirovic, Sabrina Fan, Gisela Macphail, Duncan Webster, Daniel Smyth, Sergio Borgia, Jordan J. Feld, Sam Lee, Curtis Cooper, Canadian Network Undertaking against Hepatitis C (CANUHC) Investigator Team, Lisa Barrett, Leeana Bulinckx, Brian Conway, Chris Fraser, Abuobeida Hamour, Hongqun Liu, Alnoor Ramji, Daniel Smyth, Kris Stewart, Marie-Louise Vachon, Alexander Wong, Gisela Macphail, Duncan Webster, Sergio Borgia, Jordan Feld, Curtis Cooper, Sam Lee |
| Journal | Open forum infectious diseases |
| Year | 2026 |
| DOI |
10.1093/ofid/ofag461
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| URL | |
| Keywords | Keywords not found |
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