Abstract
BackgroundThe World Health Organization set targets to eliminate hepatitis C virus (HCV) infection through detection and treatment of all cases by 2030. This study aimed to describe the progress and difficulties in the elimination of HCV infection in Navarra, Spain.MethodsUsing electronic healthcare databases, we performed a population-based prospective cohort study to describe changes in the prevalence of diagnosed active HCV infection at the beginning of 2015 and the end of 2017, the rate of new diagnoses and the rate of post-treatment viral clearance (PTVC) during this period.ResultsAt the beginning of 2015 there were 1503 patients diagnosed with positive HCV-RNA, 2.4 per 1000 inhabitants, and at the end of 2017 the prevalence had decreased by 47%. In the study period, 333 (18 per 100,000 person-years) new positive HCV-RNA cases were detected, but only 76 (23%; 4.2 per 100,000 person-years) did not have anti-HCV antibodies previously detected. Prevalent cases and new diagnoses of active infection were more frequent in men, people born in 1950–1979, HIV-infected patients and in those with lower income levels. Among patients with HCV-RNA, 984 achieved PTVC (22.7 per 100 person-years). PTVC was less frequent in patients born before 1940, in immigrants and in patients with lower income levels.ConclusionsThe prevalence of diagnosed active HCV infection has dropped by almost half over three years, because the number of patients with PTVC was much higher than the number of new diagnoses. Interventions specifically targeted at population groups with less favourable trends may be necessary.
Highlights
In the European Union about 3 million people were chronically infected with hepatitis C virus (HCV) by 2015 [1], and Spain was one of the most affected countries [2–4]
At the beginning of 2015 there were 1503 patients diagnosed with positive HCV-RNA, 2.4 per 1000 inhabitants, and at the end of 2017 the prevalence had decreased by 47%
The prevalence of diagnosed active HCV infection has dropped by almost half over three years, because the number of patients with post-treatment viral clearance (PTVC) was much higher than the number of new diagnoses
Summary
In the European Union about 3 million people were chronically infected with hepatitis C virus (HCV) by 2015 [1], and Spain was one of the most affected countries [2–4]. In 2016 the World Health Organization set targets to eliminate HCV infection as a major public health threat by 2030 [12]. These targets should be translated into operational objectives in geographical areas and population groups, including the detection of undiagnosed HCVinfections, diagnosis of active infections among HCV positive patients and antiviral treatment of active infections [13, 14]. In 2015, the National Health System in Spain launched a plan to progressively provide access of all HCV-infected patients to the DAAs regimens [15], without treatment restrictions since early 2017. The World Health Organization set targets to eliminate hepatitis C virus (HCV) infection through detection and treatment of all cases by 2030. This study aimed to describe the progress and difficulties in the elimination of HCV infection in Navarra, Spain
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