Treatment uptake among notified cases of hepatitis C virus infection in Norway, 1990 to 2022: a registry-based study to monitor progress towards elimination.

Abstract

BackgroundHepatitis C virus (HCV) infection is targeted for elimination as a public health threat by 2030. The World Health Organization goal for treatment uptake is ≥ 80% among cases diagnosed with an active HCV infection (RNA- or core antigen-positive), maintained for 2 years.AimTo calculate treatment uptake, time from diagnosis to treatment start and complete treatment dispensation among notified cases of HCV infection in Norway.MethodWe linked national data on notified cases diagnosed from 1990-2022 to dispensed prescriptions for HCV treatment from January 2004-February 2023 and data on residence status at the end of 2022. We described treatment uptake by demographic and epidemiological characteristics. We calculated the median number of months from diagnosis to treatment start by year. For direct-acting antiviral treatment periods, complete dispensation was based on the treatment and number of defined daily doses.ResultsAmong 12,178 notified cases that had an active infection at diagnosis and were still resident, 10,091 (83%) had received treatment. Uptake among resident cases was > 80% in 2021 and 2022. The median number of months from diagnosis to treatment decreased over time to 3 (interquartile range: 1-5) among cases diagnosed in 2021 and 2022. From 2015-22, 89-93% of direct-acting antiviral treatment periods annually had complete treatment dispensed.ConclusionNorway has achieved the elimination goal for treatment uptake among notified cases diagnosed with an active HCV infection. This highlights the benefit of a strategy that includes unrestricted, simplified and integrated treatment options.