Theme: Epidemiology & Public Health Research Year: 2023
Background:
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 by the end of 2023 with an ambitious goal of <5% viremic prevalence among PWID. The aim of the study was to monitor change in HCV RNA prevalence in cross-sectional samples of PWID in Oslo.
Methods:
Point prevalence studies were conducted in 2018 (August-September), 2021 (September-November) and 2022 (September) among PWID attending low-threshold health services in Oslo. Assessments included blood samples and a questionnaire about drug use. We calculated HCV RNA prevalence estimates for each year with Clopper-Pearson 95% confidence intervals, and used logistic regression analysis to identify whether undetectable HCV RNA was associated with year tested and to identify factors associated with previous self-reported HCV treatment.
Results:
A total of 281, 261 and 247 participants were included in 2018, 2021 and 2022, respectively. The median age was 41, 44 and 42 years, 74%, 73% and 77% were male, and 75%, 79% and 84% 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 10.2-19.0) in 2021 (37 of 261) and to 8.9% (95% CI 5.7-13.2) in 2022 (22 of 247).
In adjusted analysis, undetectable HCV RNA was associated with participation in 2021 (vs 2018; aOR 0.46; 95% CI 0.27-0.76), and with testing in 2022 (vs 2018; aOR 0.27; 95% CI 0.15-0.49).
In the 2021 and 2022-population, females were less likely to have received treatment (aOR 0.56; 95% CI 0.34-0.93).
Conclusion:
The substantial decrease in HCV RNA prevalence among PWID in Oslo observed between 2018 and 2022, suggests that the goal of elimination of HCV among PWID in Oslo is feasible within 2023.