Table 1:

Definitions of stages in cascade of care for hepatitis C virus (HCV) infection*

Care stageDefinition
Positive for HCV antibody
  • Positive result for HCV antibody

  • Backfilled with people who had a result from an HCV RNA test and no previous result from an HCV antibody test

Tested for HCV RNA
  • Tested for HCV RNA

Positive for HCV RNA
  • Positive result for HCV RNA

  • Excluded people who spontaneously cleared infection, identified by

    • Negative result for HCV RNA test after testing positive for HCV antibody, with no record of treatment or positive test result for HCV RNA in between

    • Negative result for HCV RNA within a year after testing positive for HCV RNA, with no record of treatment in between

HCV genotyped
  • HCV genotype result

  • Backfilled with people who were backfilled into the treatment initiated stage with no genotype record

HCV treatment initiated
  • HCV treatment initiated

  • Backfilled with people who were backfilled into the achieved SVR stage

Achieved SVR
  • For people with a record of an HCV treatment

    • If first dispensation record was for an IFN-based treatment, negative result for HCV RNA at least 40 weeks after first date of treatment

    • If first dispensation record was for a DAA treatment, negative result from HCV RNA test at least 18 weeks** after first date of treatment

    • Backfilled with people who subsequently tested negative for HCV RNA more than a year after the date of their first positive result for HCV RNA, with no record of treatment

  • Note: DAA = direct-acting antiviral, IFN = interferon, SVR = sustained virologic response.

  • * At each stage, the individual must have achieved the stage on or before Dec. 31, 2018 (for main analysis), or Dec. 31, 2013 (for comparison analysis). Additional details regarding backfilled individuals and definition of spontaneous clearance can be found in Appendix 2, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.220717/tab-related-content.

  • For backfilled people, treatment date was assumed to be 6 months before SVR date.

  • SVR date was assumed to be the date of the corresponding negative test result for HCV RNA.

  • Interferon treatment duration was assumed to be an average of 24 weeks, with SVR measured 16 weeks after treatment completion.

  • ** DAA treatment duration was assumed to be an average of 8 weeks, with SVR measured 10 weeks after treatment completion.