Monitoring Progress Towards the Elimination of Hepatitis C as a Public Health Threat in Norway: A Modelling Study Among People Who Inject Drugs and Immigrants

Abstract

Abstract Background The global incidence target for the elimination of hepatitis C among people who inject drugs (PWID) is <2/100. In Norway, the hepatitis C epidemic is concentrated in PWID. Immigrants are the second most important risk group for chronic infection. We modelled the incidence of hepatitis C among active PWID, and the prevalence of chronic infection among active PWID, ex-PWID, and immigrants in Norway to 2022. Methods We built a stochastic compartmental model, which was informed using data from national data sources, literature, and expert opinion. We report median values with 95% credible intervals (CrI). Results The model estimated 30 (95% Crl, 13–52) new infections among active PWID in 2022, or 0.37/100 (95% Crl, 0.17–0.65), down from a peak of 726 (95% Crl, 506–1067) in 2000. Across all groups, the model estimated 3202 (95% Crl, 1273–6601) chronically infected persons in 2022. Results were robust in sensitivity analyses. Conclusions Norway provides an example of the feasibility of hepatitis C elimination in a setting with a concentrated epidemic, high coverage of harm reduction services, and no treatment restrictions. Continued momentum is needed to further reduce the transmission and burden of hepatitis C in Norway.