Dear Drs. Wilson and Grad,

We are writing today to request a re-evaluation of the 2017 hepatitis C screening guidelines. We also request that the CTFPHC develop guidelines for the screening of hepatitis B.

Evidence-based screening guidelines are important to achieve our collective goal to eliminate viral hepatitis as a public health threat by 2030. The involvement of primary healthcare practitioners in viral hepatitis testing and treatment is essential.  

The CTFPHC’s 2017 Recommendations for hepatitis C screening in adults note that “This guideline may be re-evaluated as...other factors influencing the recommendations change, such as improved access to treatment.” All provinces and territories have lifted restrictions on treatment since these recommendations were published, warranting urgent re-evaluation.

Additionally, there are no published recommendations from CTFPHC for hepatitis B screening and vaccination, leaving healthcare practitioners to rely on a patchwork of inconsistent, often confusing, risk-based, provincial/territorial guidelines. Hepatitis B is an important cause of liver cancer, which can be mitigated by effective antivirals.  Unfortunately, many patients are only diagnosed with hepatitis B at the same time as their liver cancer.

Risk-based screening perpetuates the stigma of viral hepatitis, which is its own barrier to equitable access to care. Stigma was considered as a factor in the current guidelines for hepatitis C screening, and we ask you to consider the vital role that the CTFPFC can play in reducing stigma, increasing the number of Canadians who are aware of their hepatitis status, accessing treatment, and ultimately eliminating viral hepatitis as a public health threat in Canada.

Sincerely,