RETRACTED ARTICLE: The distribution and socioeconomic burden of Hepatitis C virus in South Australia: a cross-sectional study 2010–2016

Abstract

Background Hepatitis C virus infection (HCV) is a communicable disease of increasing global importance with 1.75 million new infections and 400,000 related deaths annually. Until recently, treatment options have had low uptake and most infected people remain untreated. New Direct Acting Antiviral medications can clear the virus in around 95% of cases, with few side-effects. These medications are restricted in most countries but freely accessible in Australia, yet most people still remain untreated. This study applies a cross-sectional research design to investigate the socio-spatial distribution of HCV in South Australia, to identify vulnerable populations, and examine epidemiological factors to potentially inform future targeted strategies for improved treatment uptake. Method HCV surveillance data were sourced from South Australia’s Communicable Diseases Control Branch and socio-economic population data from the Australian Bureau of Statistics from January 2010 to December 2016 inclusive. HCV cases were spatially mapped at postcode level. Multivariate logistic regression identified independent predictors of demographic risks for HCV notification and notification source. Results HCV notifications ( n = 3356) were seven times more likely to be from people residing in the poorest areas with high rates of non-employment (75%; n = 1876) and injecting drug use (74%; n = 1862) reported. Notifications among Aboriginal and Torres Strait Islander people were around six times that of non-Indigenous people. HCV notifications negatively correlated (Spearman’s rho − 0.426; p < 0.001) with socio-economic status (residential postcode socio-economic resources Index). History of imprisonment independently predicted HCV diagnoses in lesser economically-resourced areas (RR1.5; p < 0.001). Independent predictors of diagnosis elsewhere than in general practices were non-employment (RR 4.6; p = 0.028), being male (RR 2.5; p < 0.001), and younger than mean age at diagnosis (RR 2.1; p = 0.006). Conclusions Most people diagnosed with HCV were from marginalised sub-populations. Given general practitioners are pivotal to providing effective HCV treatment for many people in Australia a most concerning finding was that non-employed people were statistically less likely to be diagnosed by general practitioners. These findings highlight a need for further action aimed at improving healthcare access and treatment uptake to help reduce the burden of HCV for marginalised people, and progress the vision of eliminating HCV as a major public health threat.

Health care costs associated with chronic hepatitis C virus infection in Ontario, Canada: a retrospective cohort study

“…11 Our approach is arguably more clinically meaningful and is more suitable for economic evaluations; most modelling studies 3,4,13 include similarly defined health states. 29 Limitations of our study include that we excluded patients without valid OHIP numbers, and chronic hepatitis C disproportionately affects socioeconomically marginalized populations, 30 who may not have a permanent address from which to apply for publicly funded health insurance. We could not include costs borne by private health insurers or, more important, out-of-pocket costs paid by patients, many of whom are unable to work because of HCV infection.…”

Cannabis use is associated with a lower risk of diabetes in chronic hepatitis C‐infected patients (ANRS CO22 Hepather cohort)

“…In high‐income countries, the HCV burden is mainly felt in marginalized populations 11 such as people who inject drugs and homeless people. In Europe, injecting drug use is the main route of HCV transmission 12 .…”

Are Socio-Economic Determinants Important for Patient’s Knowledge, Attitude and Practice: Evidence from Hepatitis-C Patients

“…Another study revealed that rural population had negative attitude towards the patients of hepatitis B and C. Further results also indicated that people having low income and less education also had negative attitude towards HCV, which may be due to lack of knowledge about the disease (17). In Australia, people living in the poorest areas had high rates of unemployment and injection drug users were more likely to be infected with Hepatitis C (18). The main objective of this study was to identify the impact of socio-economic determinants on patient's knowledge, attitude and practice.…”