1 Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
2 Health Sciences Library and Informatics Center University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
3 Office of Research, Center for Healthcare Equity in Kidney Disease, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
4 Cherokee Nation Health Services, Tahlequah, Oklahoma.
5 Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque Area Indian Health Board, Inc, Albuquerque, New Mexico.
American Indian/Alaska Native (AI/AN) and Canadian Indigenous people are disproportionally affected by hepatitis C virus (HCV) infection yet are frequently under-represented in epidemiological studies and surveys that are often used to inform public health efforts. To address this issue, we performed a systematic review of published and unpublished literature and summarized our findings on HCV prevalence in these Indigenous populations. We found a disparity of epidemiologic literature of HCV prevalence among AI/AN in the United States and Indigenous people in Canada. The limited data available, which date from 1995, demonstrate a wide range of HCV prevalence in both AI/AN (1.49% to 67.60%) and Indigenous populations (2.28% to 90.24%). As injection drug use contributes to higher risk of infection, studies that either included or specifically targeted people who inject drugs reported the highest prevalence in both countries. Lower prevalence was reported in studies of general Indigenous populations, although in Canada, the lowest prevalence found in this review was up to three-fold higher in Aboriginal people compared to general population estimates. This review highlights the disparity of available data on HCV prevalence and emphasizes the need for consistent and enhanced HCV surveillance and reporting among Indigenous people. Moreover, findings support previous reports in that this disease impacts Indigenous peoples to a greater degree than the general population. It is recommended that that tribal and community leaders be engaged in enhanced surveillance efforts and that funds benefitting all Indigenous persons be expanded to help prevent and cover healthcare expenses to help stop this epidemic.