{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:38:00Z","timestamp":1792291080723,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T00:00:00Z","timestamp":1609200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000241","name":"Physicians' Services Incorporated Foundation","doi-asserted-by":"publisher","award":["#14\u201013"],"award-info":[{"award-number":["#14\u201013"]}],"id":[{"id":"10.13039\/501100000241","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Hepatitis C virus (HCV) is a common and treatable cause of cirrhosis and its complications, yet many chronically infected individuals remain undiagnosed until a late stage. We sought to identify the frequency of and risk factors for HCV diagnosis peri\u2010complication, that is within six months of an advanced liver disease complication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of Ontario residents diagnosed with chronic HCV infection between 2003 and 2014. HCV diagnosis peri\u2010complication was defined as the occurrence of decompensated cirrhosis, hepatocellular carcinoma or liver transplant within\u00a0\u00b16\u00a0months of HCV diagnosis. Multivariable logistic regression was used to identify risk factors for peri\u2010complication diagnosis among all those diagnosed with HCV infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our cohort included 39,515 patients with chronic HCV infection, of whom 4.2% (n\u00a0=\u00a01645) were diagnosed peri\u2010complication; these represented 31.6% of the 5,202 patients who developed complications in the follow\u2010up period. Peri\u2010complication diagnosis became more common over the study period and was associated with increasing age among baby boomers, alcohol use, diabetes mellitus, chronic HBV co\u2010infection and moderate to high levels of morbidity. Female sex, immigrant status, having more previous outpatient physician visits, a previous emergency department visit, a history of drug use or mental health visits were associated with reduced risk of peri\u2010complication diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Over a quarter of HCV\u2010infected patients with complications were diagnosed peri\u2010complication. This problem increased over time, suggesting a need to further expand HCV screening.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14670","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T21:24:41Z","timestamp":1600723481000},"page":"33-47","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Peri\u2010complication diagnosis of hepatitis C infection: Risk factors and trends over time"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4485-6719","authenticated-orcid":false,"given":"Lauren","family":"Lapointe\u2010Shaw","sequence":"first","affiliation":[{"name":"Department of Medicine University of Toronto Toronto ON Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto Toronto ON Canada"},{"name":"ICES Toronto ON Canada"},{"name":"University Health Network Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Chung","sequence":"additional","affiliation":[{"name":"ICES Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beate","family":"Sander","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation University of Toronto Toronto ON Canada"},{"name":"ICES Toronto ON Canada"},{"name":"University Health Network Toronto ON Canada"},{"name":"Public Health Ontario Toronto ON Canada"},{"name":"Toronto Health Economics and Technology Assessment Collaborative Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey C.","family":"Kwong","sequence":"additional","affiliation":[{"name":"ICES Toronto ON Canada"},{"name":"University Health Network Toronto ON Canada"},{"name":"Public Health Ontario Toronto ON Canada"},{"name":"Dalla Lana School of Public Health University of Toronto Toronto ON Canada"},{"name":"Department of Family and Community Medicine University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Holder","sequence":"additional","affiliation":[{"name":"ICES Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orlando","family":"Cerocchi","sequence":"additional","affiliation":[{"name":"University Health Network Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Austin","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation University of Toronto Toronto ON Canada"},{"name":"ICES Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan J.","family":"Feld","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto Toronto ON Canada"},{"name":"University Health Network Toronto ON Canada"},{"name":"Toronto Centre for Liver Disease and Toronto General Research Institute Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,29]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Public Health Agency of Canada.Report on Hepatitis B and C in Canada: 2014.2017;https:\/\/www.canada.ca\/en\/services\/health\/publications\/diseases\u2010conditions\/report\u2010hepatitis\u2010b\u2010c\u2010canada\u20102014.html#appc."},{"key":"e_1_2_11_3_1","volume-title":"Global Hepatitis Report","author":"World Health Organization","year":"2017"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21065"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0044103"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1402454"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-10-200711200-00003"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ396"},{"key":"e_1_2_11_9_1","volume-title":"Canada Communicable Disease Report","author":"Trubnikov M","year":"2014"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25556"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.06.025"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.06.025"},{"key":"e_1_2_11_13_1","volume-title":"Canadian Institute for Health Information Discharge Abstract Database: A Validation Study","author":"Juurlink DN","year":"2006"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0201120"},{"key":"e_1_2_11_15_1","volume-title":"Living and Dying in Ontario: An Opportunity for Improved Health Information","author":"Iron K","year":"2008"},{"key":"e_1_2_11_16_1","volume-title":"CIHI Data Quality Study of Ontario Emergency Department Visits for Fiscal Year 2004\u20132005\u2014Executive Summary","author":"Canadian Institute for Health Information","year":"2007"},{"issue":"15","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1001\/jama.2017.14418","article-title":"Association Between Immigrant Status and End\u2010of\u2010Life Care in Ontario, Canada","volume":"318","author":"Yarnell CJ","year":"2017","journal-title":"Jama"},{"key":"e_1_2_11_18_1","unstructured":"Johns Hopkins University.Johns Hopkins ACG Case\u2010Mix Adjustment System.https:\/\/www.hopkinsacg.org\/. Accessed April 11 2019."},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0021748"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3148-0"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.04.030"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-2229"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229218"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26141"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2008.06.018"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.170453"},{"key":"e_1_2_11_27_1","unstructured":"US Preventive Services Task Force.Final recommendation statement \u2014 hepatitis C: screening.2013;https:\/\/www.uspreventiveservicestaskforce.org\/Page\/Document\/RecommendationStatementFinal\/hepatitis\u2010c\u2010screening. Accessed March 27 2019."},{"issue":"4","key":"e_1_2_11_28_1","first-page":"1","article-title":"Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945\u20101965","volume":"61","author":"Smith BD","year":"2012","journal-title":"MMWR Recomm Rep"},{"issue":"6","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/j.jhep.2019.06.015","article-title":"Pitfalls in measuring temporal trends for late diagnosis of viral hepatitis","volume":"71","author":"Lapointe\u2010Shaw L","year":"2019","journal-title":"J Hepatol"},{"key":"e_1_2_11_30_1","volume-title":"Global Health Sector Strategy on Viral Hepatitis 2016\u20132021","author":"World Health Organization","year":"2016"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.14670","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/liv.14670","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.14670","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T15:46:05Z","timestamp":1693755965000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.14670"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,29]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1111\/liv.14670"],"URL":"https:\/\/doi.org\/10.1111\/liv.14670","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,29]]},"assertion":[{"value":"2020-04-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}