Hepatitis C: An In-Depth Guide

A brief history of hepatitis C: 1989 - 2017

1989
  • The hepatitis C virus (HCV) is discovered and is quickly established as the major cause of non-A, non-B hepatitis.

   
1990
  • A hepatitis C screening test is developed. Blood banks across Canada begin screening blood donations for hepatitis C.

   
1991
  • The first alpha interferon is approved for the treatment for hepatitis C.

  • Hepatitis C becomes a notifiable disease in Canada. Non-A, non-B hepatitis is removed from the list of notifiable diseases in 1999.

   
1992
  • A more sensitive screening test is developed and used to screen blood donations for hepatitis C, effectively eliminating hepatitis C transmission through the blood supply in Canada. It is estimated that 90,000 to 160,000 Canadians contracted hepatitis C through infected blood or blood products between 1960 and 1992.

  • In response to growing concerns about the efficiency, effectiveness and safety of Canada’s blood system, the House of Commons Standing Committee on Health and Welfare, Social Affairs, Seniors and the Status of Women form a subcommittee to report on the subject.

   
1993
  • Commission of Inquiry on the Blood System in Canada (called the Krever Inquiry) begins.

   
1994
  • The Hepatitis C Society of Canada (HeCSC) is founded by Dr. Alan T.R. Powell. The HeCSC is a national voluntary health organization whose mission is to fight hepatitis C through prevention, early detection, treatment and support. Over time, the HeCSC grows to around 40 chapters across Canada, offering support groups, local peer counseling, publications and seminars.

   
1996
  • The Egyptian Ministry of Health estimates that 15 to 20 percent of Egyptians are infected with HCV. Similar to the experience of many countries including Italy, the Ministry links the epidemic to a nationwide vaccination campaign, during which needles were re-used. Egypt continues to report the highest hepatitis C rate in the world.

   
1997
  • The final report from the Commission of Inquiry on the Blood System in Canada is published.

   
1998
  • The Canadian government agrees to offer financial assistance to Canadians infected with hepatitis C through the blood system between January 1, 1986, and July 1, 1990.

  • Health Canada holds a national consensus conference in Ottawa: Hepatitis C – Prevention and Control: a Public Health Consensus.

  • The Canadian government establishes the Enhanced Hepatitis Strain Surveillance System (EHSSS), a national initiative to investigate newly identified cases of HCV and acute hepatitis B virus (HBV) from participating sites.

   
1999
  • Health Canada approves the first combination of alpha interferon and ribavirin for the treatment of hepatitis C.

  • The Canadian government launches the Hepatitis C Prevention, Support and Research Program as part of its response to the report of the Commission of Inquiry on the Blood System in Canada. Scheduled to finish in 2004, the program will go on to receive three separate one-year extensions before finally wrapping up in 2007.

  • The Atlantic Hepatitis C Coalition (now Hepatitis Outreach Society of Nova Scotia) is founded in Nova Scotia.

  • The first glass stems are distributed as part of safer crack kits.

   
2001
  • Pegylated interferon is developed for the treatment of hepatitis C.
   
2002
  • CATIE-News reports on the possible sexual transmission of hepatitis C among men who have sex with men. This controversial and initially discounted mode of transmission is now well-established.

  • Actress Pamela Anderson publicly announces that she has hepatitis C. She speaks openly about living with hepatitis C and kicks off a 2002 Canadian Liver Foundation (CLF) hepatitis campaign.

  • The Hepatitis C Council of BC (now the Pacific Hepatitis C Network) is founded in British Columbia.

  • The 1st National Aboriginal Hepatitis C Conference, hosted by NECHI Training, Research and Health Promotions Institute, takes place in Edmonton, Alberta.

   
2003
  • Insite, North America’s first supervised injection facility, opens its doors in Vancouver, British Columbia.

  • The Canadian Public Health Association announces the establishment of the Canadian Hepatitis C Information Centre. The Centre is to be a multi-service information centre (online, in print and by telephone) that collects and circulates hepatitis C educational materials across the country.

  • The Centre Associatif Polyvalent d’Aide Hépatite C is founded in Québec.

  • The 2nd National Aboriginal Hepatitis C Conference, hosted by Chee Mamuk, takes place in Vancouver, British Columbia.

   
2004
  • The 5th edition of the Canadian AIDS Society’s HIV Transmission: Guidelines for Assessing Risk includes a section on hepatitis C transmission. This addition is “acknowledging the many AIDS Service Organizations and front-line workers who have taken on the role of delivering HCV transmission information in the absence of an official strategy from Health Canada on coping with this second epidemic.”

  • Hepatitis C virus transmission in the prison/inmate population is published in the Public Health Agency of Canada's (PHAC) Communicable Disease Report. It highlights a significant disproportionate hepatitis C prevalence rate among people in prison (between 19.2% and 39.8%) compared to the general population in Canada (approximately 0.8%).

  • The Ontario Ministry of Health and Long-Term Care (MOHLTC) establishes the Ontario Hepatitis C Secretariat to develop policies and programs that meet the needs of people with hepatitis C in that province.

  • The 2nd Canadian Conference on Hepatitis C is held in Vancouver, British Columbia.

  • A provincial committee on hepatitis C, the Comité de travail sur l'état de la situation sur l'hépatite C, is established in Québec.

   
2005
  • Correctional Service Canada (CSC) and PHAC collaborate in the development of the ‘Safer Tattooing Practices Initiative’ pilot project, launched in several men’s federal institutions and one women’s institution.

   
2006
  • By 2006, prison needle exchange programs have been established or piloted in a number of countries around the world including Switzerland, Germany, Spain, Moldova, the Kyrgyz Republic, Armenia and Iran.

  • The Safer Tattooing Practices Initiative evaluation report prepared by CSC concludes, among other things, that “initial results of the initiative indicate potential to reduce harm, reduce exposure to health risk, and enhance the health and safety of staff members, inmates and the general public with higher risk groups.” The initiative is canceled.

  • Commissioned by CSC, PHAC prepares a report of scientific and technical advice on the potential benefits and risks of prison needle exchange programs. The report concludes that, in other jurisdictions, these programs significantly reduce disease transmission and there is no evidence that they increase drug use or compromise institutional safety.

   
2007
  • The World Hepatitis Alliance is founded.

  • The new National Anti-Drug Strategy is the first in many years to explicitly exclude funding for—or even any mention of—harm reduction measures, while adding significant new funding for additional efforts to enforce criminal laws on drugs.

  • The Pre-1986/Post-1990 Hepatitis C Class Action Settlement Agreement is approved by the courts. This is a compensation plan for people infected with hepatitis C through the blood system in Canada before 1986 or after 1990.

  • Without a commitment of funding for the next year, many hepatitis service organizations close their doors, including the Canadian Hepatitis C Information Centre and the Hepatitis C Society of Canada.

  • The 4th National Aboriginal Hepatitis C Conference, hosted by Akaitcho Territory Government, takes place in Yellowknife, Northwest Territories.

  • CASL convenes a 2nd national consensus conference on the management of viral hepatitis.

   
2008
  • The World Hepatitis Alliance launches the first World Hepatitis Day on May 19 with a campaign called Am I Number 12? This refers to the statistic that, worldwide, one in every 12 people is living with a form of viral hepatitis. A World Hepatitis Day in Canada planning committee is established under the leadership of CLF. Advocacy and awareness-raising activities are organized across Canada including the development of six Canadian government “Asks”.

  • Canada’s federal Minister of Health, Tony Clement, announces the renewal of the Hepatitis C Prevention, Support and Research Program with the commitment of ongoing funding, annually.

   
2009
  • The Canadian government releases the document A Strategic Framework for Action outlining Canada’s future directions, priorities and long term plan to address hepatitis C.

   
2010
  • The Vienna Declaration, a statement seeking to improve community health and safety by calling for the incorporation of scientific evidence into illicit drug policies, is launched at the 18th International AIDS Conference in Vienna, Austria.

  • The 63rd World Health Assembly of the World Health Organization (WHO) passes a viral hepatitis resolution, recognizing, among other points, “the need to reduce incidence to prevent and control viral hepatitis, to increase access to correct diagnosis and to provide appropriate treatment programmes in all regions.”

  • The WHO endorses July 28th as World Hepatitis Day, making it the fourth official global health awareness day, alongside HIV, malaria and tuberculosis.

  • The 1st Canadian HIV/HBV/HCV Co-infection Research Summit is held in Toronto, Ontario. It is organized by the Canadian Treatment Action Council (CTAC) in partnership with many national and community-based organizations.

   
2011
  • Following many legal battles, the Supreme Court of Canada rules that Insite can continue to operate under a constitutional exception to the Controlled Drugs and Substances Act. Since this ruling, discussions on supervised injection facilities have gained momentum in cities across the country.

  • Almost ten years after the last development in hepatitis C treatment, two new medications are approved for genotype 1 hepatitis C.

  • The MOHLTC establishes multidisciplinary treatment and support teams throughout the province to expand access to care and improve treatment outcomes.

  • Musicians Gregg Allman, Natalie Cole and Jon Secada turn up the volume around hepatitis C at Tune in to Hep C, a US-based public health campaign created to raise awareness about the virus.

  • On the occasion of World Hepatitis Day 2011, the Canadian Coalition of Organizations Responding to Hepatitis B and C releases a report card that, using the six Canadian “Asks,” assesses provincial, territorial and federal government responses to hepatitis C.

  • The WHO sponsors its first official World Hepatitis Day with the theme, “This is Hepatitis … Know it. Confront it. Hepatitis affects everyone, everywhere.” The WHO supports activities around the world through collaboration with civil society.

  • CASL convenes a 3rd national consensus conference on the management of viral hepatitis.
   
2012
   
2013
  • The Canadian Liver Foundation releases Liver Disease in Canada: A Crisis in the Making. This report outlines the scope of liver disease in Canada and urges federal, provincial and territorial governments and related health agencies to work together to develop a national liver disease strategy.
  • B.C. announces $1.9 million in funding for Hep B and C research and education, awareness-raising and prevention of hepatitis B among immigrant communities.
   
2014
  • Two new powerful Hep C medications, sofosbuvir (Sovaldi) and simeprevir (Galexos) are approved by Health Canada
  • HepCBC Hepatitis C Education and Prevention Society (HepCBC)  launches the HCV Manifesto
  • Harvoni approved by Health Canada
   
2015
  • Combination of sofosbuvir and simeprevir approved by Health Canada
  • Sofosbuvir and Harvoni added to many provincial and territorial formularies, providing  broad access to interferon-free regimens
  • P.E.I announces a five million dollar hepatitis C strategy
  • Telaprevir discontinued in Canada
  • Daclatasvir and Technivie ( a combination of ombitasvir, paritaprevir and ritonavir) are approved by Health Canada
  • Holkira Pak is added to all provincial and territorial formularies
   
2016
  • Epclusa (velpatasvir and sofosbuvir) approved by Health Canada
  • Zepatier (elbasvir and grazoprevir) approved by Health Canada
  • Common Drug Review recommends treating everyone for Hep C regardless of level of liver injury, starting with those with the most liver injury
  • Boceprevir discontinued in Canada
   

 

2017

  • Alberta, B.C., Nova Scotia, Ontario, Quebec and Saskatchewan change their formularies to increase access to hepatitis C treatments.
  • Ontario, Quebec and BC commit to unrestricted hepatitis C treatment access in 2018.
  • Peg-interferon no longer available in Canada for treating hepatitis C.
  • Health Canada approves the use and sale of a point-of-care hepatitis C antibody test. It is called the OraQuick HCV Rapid Antibody Test.
  • Canada’s first recommendations for hepatitis C screening are released by The Canadian Taskforce for Preventative Health Care (CTPHC). The guidelines, which apply to the general adult population, do not recommend population-wide screening for older adults, instead they recommend continuing to screen people at higher risk of infection, such as people with a history of injection drug use.
  • The Canadian Liver Foundation (CLF), Action Hepatitis Canada (AHC) and several Canadian liver experts criticise the screening recommendations.