ArticleLiver international : official journal of the International Association for the Study of the Liver2026
Impact of Antiviral Therapy Scale-Up Among People Who Inject Drugs in Scotland: Regional Evidence of Hepatitis C Virus Elimination.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Impact of Antiviral Therapy Scale-Up Among People Who Inject Drugs in Scotland: Regional Evidence of Hepatitis C Virus Elimination.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
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14 authors.
Funding
Abstract
backgroundExpansion of highly effective direct-acting antiviral (DAA) treatment for people who inject drugs (PWID) is regarded as essential to achieve hepatitis C virus (HCV) elimination. A decade since the introduction of DAA treatment, we aimed to assess its roll-out and associated impact in reducing HCV prevalence among PWID in Scotland, as part of a treatment-as-prevention (TasP) strategy.
methodsNational bio-behavioural surveys of PWID (recruited at services providing injecting equipment) between 2010 and 2023 (N = 16 973), involving a questionnaire and blood spot sample (tested for HCV-antibodies and HCV-RNA), were used to examine treatment uptake and HCV viraemia prevalence (overall and among those with antibodies) for Tayside, Greater Glasgow & Clyde (GGC), and Rest of Scotland (RoS). We used a flexible Bayesian logistic regression model to estimate HCV prevalence and probability of having achieved an 80% reduction in HCV prevalence since 2015.
resultsBetween 2015-16 and 2022-23, uptake of DAAs (ever) increased 2.7-, 5.6- and 4.5-fold to 95%, 78% and 76% in Tayside, GGC and RoS, respectively. Over this period, observed viraemia prevalence declined to 4%, 16% and 15% (involving 86%, 65% and 53% decline) in Tayside, GGC and RoS, respectively. In Tayside, modelled viraemia prevalence among those with antibodies declined from 62% in 2015 to 11% in 2023, with a 53% probability that the WHO proxy target of an 80% reduction in HCV prevalence was met.
conclusionOur study provides real-world evidence for TasP, demonstrating that HCV elimination among PWID is feasible through community-wide scale-up of DAAs and population-level monitoring surveys.
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