title: Decreasing Hepatitis C Incidence Among a Population With Repeated Tests: British Columbia, Canada, 1993-2011.
abstract: OBJECTIVE
  We estimated HCV incidence among individuals who repeatedly underwent anti-HCV testing.
  
  
  METHODS
  We studied HCV-negative individuals who had at least 2 tests between April 1992 and September 2012 in British Columbia, Canada. We calculated incidence as the number of new infections per 100 person-years at risk.
  
  
  RESULTS
  From 1992 to 2012, 323 598 individuals who persistently tested negative and 7490 HCV seroconverters contributed 1 774 262 person-years of observation time. Incidence rates ranged from 2.66 infections per 100 person-years (95% confidence interval [CI] = 2.07, 3.35) in 1993 to 0.25 infections per 100 person-years (95% CI = 0.21, 0.29) in 2011. Rates declined sharply in the 1990s and declined more gradually in the 2000s. Incidence declined with age; highest incidence rates were among those aged 15 to 24 years. Incidence among male repeat testers exceeded that of female repeat testers across all years, although the gap narrowed over time.
  
  
  CONCLUSIONS
  Addictions treatment, harm reduction, prevention education, and novel initiatives to remove barriers in health infrastructure need to be intensified for those who inject drugs, particularly men and younger persons.
authors.affiliation: At the time of the writing, all of the authors were with the British Columbia Centre for Disease Control, Vancouver, Canada. Ann N. Burchell is with the Ontario HIV Treatment Network, Toronto, Canada.
authors.forename: Margot
authors.initials: M
authors.lastname: Kuo
authors.affiliation: At the time of the writing, all of the authors were with the British Columbia Centre for Disease Control, Vancouver, Canada. Ann N. Burchell is with the Ontario HIV Treatment Network, Toronto, Canada.
authors.forename: Naveed Z
authors.initials: NZ
authors.lastname: Janjua
authors.affiliation: At the time of the writing, all of the authors were with the British Columbia Centre for Disease Control, Vancouver, Canada. Ann N. Burchell is with the Ontario HIV Treatment Network, Toronto, Canada.
authors.forename: Ann N
authors.initials: AN
authors.lastname: Burchell
authors.affiliation: At the time of the writing, all of the authors were with the British Columbia Centre for Disease Control, Vancouver, Canada. Ann N. Burchell is with the Ontario HIV Treatment Network, Toronto, Canada.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Buxton
authors.affiliation: At the time of the writing, all of the authors were with the British Columbia Centre for Disease Control, Vancouver, Canada. Ann N. Burchell is with the Ontario HIV Treatment Network, Toronto, Canada.
authors.forename: Mel
authors.initials: M
authors.lastname: Krajden
authors.affiliation: At the time of the writing, all of the authors were with the British Columbia Centre for Disease Control, Vancouver, Canada. Ann N. Burchell is with the Ontario HIV Treatment Network, Toronto, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Gilbert
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001955:British Columbia / Q000453:epidemiology; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012698:Serologic Tests / Q000706:statistics & numerical data; D012737:Sex Factors; D055815:Young Adult