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Background:
In 2022 a Hepatitis Team was appointed for implementation of the Swedish national hepatitis C elimination plan in Skåne Region. The team gathers monthly at the Regional Office of Communicable Disease Prevention and Control (RCDPC), consisting of representatives from all Infectious disease clinics, the Clinical Microbiology laboratory, Addiction care, Primary care, Prison health and the Drug Users Union.
Methods:
Initially a gap analysis was conducted, confirming that routines for testing and treating hiv, HBV and HCV are functioning well at all four Needle and syringe programs. Guidelines for testing are present at all 26 OAT (opiate agonist therapy) units and within Prison health care. A routine for reflex testing with HCV RNA PCR of samples positive for anti-HCV has been implemented at the laboratory. The RCDPC conducted an analysis of all reported HCV cases.
Results:
The level of HCV RNA among NSP participants declined from approximately 50 % in 2018 to below 10 % in 2024. Despite the data from the OAT units not being fully comprehensive, HCV treatment had been offered extensively and HCV RNA prevalence was estimated to have decreased to < 10 %. The number of reported cases in the region had decreased from 151 cases in 2022 to 121 in 2023 (with 19 %) and 112 in 2024 (9 %). Approximately 25 % of the cases were incident infections (96 % among people who inject drugs), 25 % newly detected chronic infections and 50 % newly detected infections of unknown duration.
Conclusion:
Even if progress in HCV elimination in Skåne Region can be shown, the need for further improvement is imminent. Incident infections are mainly detected through NSP, yet sustainable prevalence and incidence data must be obtained also from other settings. Interventions for outreach testing, information distribution and improved data collection are now being launched.
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