The Road Towards Elimination of Hepatitis C in Oslo: Cross-Sectional Prevalence Studies in 2018 and 2021

Author: Eirik Opheim Kjersti Ulstein Øystein Backe Tarjei Foshaug Hanne Sørli Linda Wüsthoff Håvard Midgard Olav Dalgard

Theme: Epidemiology & Public Health Research Year: 2022

The prevalence of chronic HCV infection among people who inject drugs (PWID) in Oslo was 40-45%
in the pre DAA era. Norway aims to eliminate HCV infection within 2023 with an ambitious goal of
<5% viremic prevalence among PWID. The aim of the study was to monitor HCV RNA prevalence in
cross-sectional samples of PWID in Oslo.
Point prevalence studies were conducted in 2018 (August-September) and 2021 (SeptemberNovember) among PWID attending low-threshold health services in downtown Oslo. Assessments
included blood samples and a questionnaire about drug use. HCV RNA prevalence estimates with
Clopper-Pearson exact 95% CIs were calculated for 2018 and 2021. Factors associated with
detectable HCV RNA were analysed among participants in 2021 using logistic regression analysis.
A total of 291 and 264 participants were included in 2018 and 2021, respectively. The median age
was 41 and 44 years, 74% and 73 % were male, and 75% and 79% reported recent (past 4 weeks)
injecting drug use, respectively. HCV RNA prevalence decreased from 26.3% (95% CI 21.3-31.9) in
2018 (74 of 281) to 14.2% (95% CI 10.2-19) in 2021 (37 of 261). A significant decrease in HCV RNA
prevalence was observed among individuals >40 years, those with >20 years of injecting, those who
reported recent injecting drug use, and those who reported sharing of injecting equipment in the
past four weeks (Figure). Detectable HCV RNA was associated with recent injecting drug use (OR
11.7; 95% CI 1.6-87.5). Anti-HCV/HCV RNA ratios decreased in all subgroups between 2018 and
The substantial decrease in HCV RNA prevalence among PWID in Oslo observed between 2018 and
2021 is likely to be due to increased treatment uptake. Further increases in treatment uptake will be
necessary to reach the Norwegian elimination goals.
Disclosure of Interest Statement:
ØB has received lecture fees from Abbvie, MSD and Gilead. KU has received lecture fees from Abbvie,
MSD and Gilead and research grant from Gilead. OD has received lecture fees from Abbvie and
research grants from Abbvie and MSD. HM has received lecture fees from Abbie, Gilead and MSD. No
pharmaceutical grants were received in the development of this study.

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