Towards elimination of hepatitis C in Oslo: Cross-sectional prevalence studies in 2018, 2021, and 2022.

Author: Thorgerdur Einarsdottir, Valgerður Rúnarsdóttir, Sigurður Ólafsson, Kristján Godks Rögnvaldsson, Ubaldo Benitez Hernandez, Magnús Gottfreðsson

Theme: Epidemiology & Public Health Research Year: 2023

Hepatitis C virus (HCV) can spread among people who inject drugs (PWID) by sharing injection equipment. HCV can cause a chronic infection which may lead to liver failure, cirrhosis, and hepatocellular carcinoma. These complications are preventable through early detection and antiviral treatment. However, addiction also carries increased risk of premature death from multiple other causes. The aim of this study was to investigate survival among PWID with or without HCV infection who sought addiction treatment at Vogur Hospital, the main addiction center in Iceland, 2000-2022.

If patients reported injection drug use, screening for HCV was performed on admission, providing information on HCV status (antibody status and HCV RNA by PCR if antibody was positive). Survival status was obtained from the national population registry. Binomial regression model was used to calculate the association between HCV infection and death. Survival was calculated using multivariate Cox analysis among the individuals who had two or more HCV test results, adjusting for age and sex.

Vogur Hospital treated 2,388 PWID as inpatients between January 1st 2000 and March 7th 2022. PWID with history of HCV were significantly more likely to die compared to PWID with no history of an HCV infection with an odds ratio of 1.99 (95% confidence interval 1.6 – 2.5; p<0.001). By multivariate Cox analysis and adjustment for age and sex those with an active infection (positive HCV RNA) had a relative risk of death of 1.3 (95% confidence interval 1.02 – 1.67; p = 0.036).

In this long-term, nationwide cohort, PWID in Iceland with HCV had a 30% higher risk of death compared to those who were uninfected. It is not known whether this increase is directly attributable to the HCV infection itself or if acquisition of HCV may be a marker for greater severity of their addiction.

Disclosure of Interest Statement:
The authors have no conflicts of interest to declare. No grants or funds were received for the project and this abstract is based on a thesis for a bachelor’s degree in Medicine. 

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