Theme: Epidemiology & Public Health Research Year: 2022
Background
Globally, 71 million people are estimated as living with chronic hepatitis C virus (HCV) infection,
with approximately 2 million new infections annually. One of the goals of the UN 2030 Agenda
for Sustainable Development and the WHO Viral Hepatitis Strategy is the elimination of viral
hepatitis as a public health threat. In Portugal, 100,000 – 150,000 people are estimated as HCV
chronic carriers, of which 50,000 have already been treated. Among People Who Inject Drugs
(PWID), the HCV prevalence is estimated at around 80%. Screening for HCV infection and
subsequent linkage to care is essential to achieving the benefits of direct-acting antivirals (DAA).
Methods
From March 2018 to March 2020, we enrolled PWID attending Needle and Syringe Programmes
in Lisbon. Face-to-face interviews were performed by trained harm reduction workers collecting
sociodemographic information, drug use patterns, associated behaviours, and HCV testing
history. An HCV point-of-care rapid test was used, and those with HCV Ab+ were offered linkage
to care at a reference hospital.
Results
175 PWID were included in the study. These individuals had a mean age of 42.1±8.33 y.o., mainly
males (89.7%; n=157), 37.7% (n=66) were living in the street in the previous 12 months. In terms
of drug consumption, the mean age of first-time injection was 23.2±8.54 y.o., most were
injecting heroin (82.9%; n=145), powder cocaine (63.4%; n=111) and crack cocaine (43.4%; n=76)
in the last 30 days. Of all, 123 individuals had a reactive result for HCV Ab test, providing an HCV
prevalence estimate of 70.3% (95% CI: 62.9%-76.9%).
Conclusion
In Portugal, DAA are available since 2015, but PWID still present treatment uptake rates below
standards. This study represents the first HCV prevalence estimate among active PWID,
contributes to a better estimate of the those in need of HCV treatment and to increase
knowledge on this population.
Disclosure of Interest Statement
This research was funded by Gillead Sciences and Merck Sharp & Dhome. The funders. The
funders had no role in study design, data collection, analysis or decision to publish.