Trends in chronic hepatitis C infection among people who inject drugs in England: real world data, 2011-2018

Author: Megan Bardsley

Theme: Epidemiology and Public Health Research Year: 2021

Background: England is striving to meet global elimination goals for hepatitis C virus (HCV) and have scaled-up treatment using direct-acting antivirals (DAAs) since 2015. To monitor progress toward elimination, we used 8 years of national surveillance data to examine trends in chronic HCV infection among the key affected population of people who inject drugs (PWID). Methods: Questionnaire and virological data from the Unlinked-Anonymous Monitoring Survey of PWID in England from 2011 to 2018 were analysed (2019 data awaited). Temporal changes in the proportion chronically infected (HCV RNA positive) among those ever infected (anti-HCV positive) were examined in a multivariable model. HIV-positive samples or those insufficient for antiHCV/RNA testing were excluded. Region, gender, age and injecting status in the past year were a priori confounders. Results: A total of 8,916 PWID were included. Between 2011 and 2018, the proportion anti-HCV positive increased from 40.9% (942/2,302) to 53.8% (1,148/2,135). The proportion chronically infected among those anti-HCV positive was similar pre-DAA scale-up (2011, 58.4%; 2012, 58.0%; 2013, 55.7%; 2014, 57.0%; 2015, 55.5%; 2016, 56.6%) but decreased post-DAA scale-up (2017, 49.5%; 2018, 50.3%). After adjustment, year remained associated with chronic infection (p

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