Are you up-to-date?

Hepatitis C testing and treatment recommendations have changed. Ontario is updating its hepatitis C guidance to align with international recommendations. In the meantime, care providers can look to national and international screening recommendations, including:

• Public Health Agency of Canada’s Hepatitis C virus (hepatitis C): Screening and testing for health professionals
• American Association for the Study of Liver Disease (AASLD)’s Recommendations for Testing, Managing, and Treating Hepatitis C
• Society for Obstetricians and Gynaecologists of Canada’s Clinical Consensus Statement No. 458: Hepatitis C Virus in Pregnancy

The right time to treat is now.

A significant number of people with hepatitis C remain undiagnosed because they were never identified as having risk factors. Many first present to care only after developing advanced liver disease.

Why Test for Hepatitis C?

Expanding screening is key to reaching the large number of people who remain undiagnosed.

Public Health Ontario has strengthened hepatitis C testing by making reflex testing routine. When a sample tests positive for hepatitis C antibodies for the first time, a confirmatory hepatitis C RNA (viral load) test is now performed automatically. This removes the need for a second blood draw and helps increase confirmatory testing rates, supporting faster linkage to treatment.

Hepatitis C treatment is curative 

Hepatitis C can now be cured with oral, daily medications, taken for eight to 12 weeks. These direct-acting antivirals (DAAs) are safe, highly effective (95%+ cure rate) and well tolerated. 

The majority of hepatitis C infections do not require a specialist to treat. 

Currently, curative hepatitis C care is offered in a variety of settings across Ontario, including:

• Primary care
• Sexual health and PreP clinics
• Mobile and outreach services
• Substance use and harm reduction services
• In-patient settings
• Federal and provincial correctional facilities

Hepatitis C treatment is disease prevention

Curing hepatitis C halts related progressive liver damage, prevents liver cancer, improves all-cause mortality, and eliminates the risk of onward transmission. 

Ontario has invested in hepatitis C prevention and treatment. Publicly funded supports include harm reduction programs and workers, a limited number of supervised consumption services (referred to as consumption and treatment services in Ontario), and rapid access addiction medicine (RAAM) clinics. The province also provides Ontario‑wide access to new, sterile drug‑use equipment through public health units and their community partners.

Opioid agonist treatment (OAT) / medically assisted therapy

Rapid access addiction medicine (RAAM) clinics are walk-in clinics for people with substance use disorder. RAAM clinics provide quick access to addiction services without a referral or appointment.

Safer substance use resources

Resources created for people who use drugs (substances) and service providers are designed to help you learn the basics of snorting, smoking and injecting drugs as safely as possible to prevent transmission of hepatitis C, HIV and other infections. 

The CATIE Ordering Centre distributes HIV and hepatitis C resources, including safer substance use resources, free-of-charge to service providers across Canada.

Harm reduction supplies

Combined opioid agonist treatment (OAT) and high-coverage needle syringe programs (defined as providing a person with at least one sterile needle per injection) can reduce hepatitis C incidence by up to 80%, whereas OAT alone can reduce hepatitis C transmission by 50%-60%.

Since 2006, the Ontario Harm Reduction Distribution Program (OHRDP) has been coordinating the distribution of evidence-based harm reduction supplies to Core Harm Reduction Programs throughout Ontario. Working with a licensed medical distributor, OHRDP coordinates the procurement, management and distribution of harm reduction supplies. 

Your hub for hepatitis C clinical tools and training

Access supports to integrate hepatitis C testing and treatment into your everyday practice.

Explore our growing resource library, designed to support you with up-to-date practical tools and guidance, including:

• Clinical guidelines
• Simplified workflow
• Testing and treatment recommendations
• Free continuing education opportunities
• Practical tools for clinical practice

Everything you need, all in one place.

Contact us if you have questions or want to learn more.