American Indian/Alaska Native (AI/AN) and Canadian Indigenous people are disproportionally affected by hepatitis C virus (HCV) infection yet are frequently underrepresented in epidemiologic studies and surveys often used to inform public health efforts. We performed a systematic review of published and unpublished literature and summarized our findings on HCV prevalence in these Indigenous populations.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 AI/AN (1.49%–67.60%) and Indigenous populations (2.28%–90.24%). The highest HCV prevalence in both countries was reported in studies that either included or specifically targeted people who inject drugs. Lower prevalence was reported in studies of general Indigenous populations, although in Canada, the lowest prevalence was up to 3-fold higher in Aboriginal people compared with general population estimates. The disparity of available data on HCV prevalence and need for consistent and enhanced HCV surveillance and reporting among Indigenous people are highlighted. HCV affects Indigenous peoples to a greater degree than the general population; thus we recommend tribal and community leaders be engaged in enhanced surveillance efforts and that funds benefitting all Indigenous persons be expanded to help prevent and cover health care expenses to help stop this epidemic.

中文翻译：

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美国和加拿大的土著居民中的丙型肝炎病毒感染。

美洲印第安人/阿拉斯加原住民（AI / AN）和加拿大原住民受到丙型肝炎病毒（HCV）感染的影响不成比例，但在流行病学研究和调查中常常被忽视，常被用于指导公共卫生工作。我们对已发表和未发表的文献进行了系统的综述，并总结了我们在这些土著人群中HCV流行情况的发现。我们发现美国AI / AN与加拿大原住民之间HCV流行的流行病学文献存在差异。可追溯到1995年的有限数据表明，AI / AN（1.49％–67.60％）和土著人口（2.28％–90.24％）的HCV患病率范围很广。在包括或专门针对注射毒品的人群的研究中，这两个国家的HCV患病率最高。据报告，对普通土著人口的患病率较低，尽管在加拿大，与普通人口估计数相比，原住民的最低患病率高3倍。着重指出了关于丙肝流行率的现有数据的差异，以及对土著居民进行持续和加强的丙肝监测和报告的需求。HCV对土著人民的影响程度要比普通人群更大。因此，我们建议部落和社区领导人加强监督工作，并扩大惠及所有土著人民的资金，以帮助预防和支付医疗费用，以制止这种流行病。着重指出了关于丙肝流行率的现有数据的差异，以及对土著居民进行持续和加强的丙肝监测和报告的需求。HCV对土著人民的影响程度要比普通人群更大。因此，我们建议部落和社区领导人加强监督工作，并扩大惠及所有土著人民的资金，以帮助预防和支付医疗费用，以制止这种流行病。着重指出了有关HCV流行率的现有数据之间的差异以及对土著居民进行持续和加强的HCV监测和报告的需求。HCV对土著人民的影响程度要比普通人群更大。因此，我们建议部落和社区领导人加强监督工作，并扩大惠及所有土著人民的资金，以帮助预防和支付医疗费用，以制止这种流行病。