Estimating progress on hepatitis C elimination targets among people in contact with drug services in Scotland: National retrospective cohort study.

Authors

Alan Yeung, Elinor Curnow, Amanda Weir, Andrew McAuley, Lukasz Henszel, Lee Barnsdale, Duncan McCormick, Matthew Hickman, Sharon Hutchinson

Published in

The International journal on drug policy. Volume 158. Pages 105565. Oct 22, 2026. Epub Oct 22, 2026.

Abstract

Scotland's HCV elimination strategy has focused efforts on scaling up treatment in community-based settings, with population-based surveys indicating substantial reductions in HCV prevalence among people who inject drugs. We aimed to evaluate progress against World Health Organization (WHO) elimination targets using a national virtual cohort of individuals in contact with drug services in Scotland.
The cohort was formed utilizing national administrative databases (including opioid agonist therapy prescribing, drug-related hospitalizations and specialist drug treatment) and linked to HCV databases to ascertain diagnosed infection status during January 2015-March 2024. Multi-state and logistic regression models were used to estimate undiagnosed infection among individuals not tested during follow-up.
Among 78,444 individuals who attended drug services, 15,851 (20.2%) had died or migrated during follow-up. Among 62,593 remaining in the prevalent cohort, 12,553 had been diagnosed with HCV, with 86.8% treated. We estimated 2415 (95% CI 1827-3467) individuals had undiagnosed HCV; thus, 83.2% (77.0%-86.9%) of infection had been diagnosed. Prevalence decreased by an estimated 71.7% (66.0%-75.1%), accounting for estimated undiagnosed infection. During January 2015-March 2024, estimated (diagnosed and undiagnosed) HCV incidence was 1.73 (1.56-2.05) and 2.13 (1.97-2.46) per 100 person-years for the overall cohort and those with a recent opioid-related drug service attendance, respectively.
Scotland has made significant progress towards HCV elimination targets, with high levels of diagnosis and treatment achieved among people in contact with a broad range of drug services. Further, we demonstrate that linkage of administrative data has an important role to play in evaluating progress on HCV elimination.

PMID:
42913206
Bibliographic data and abstract were imported from PubMed on 24 Oct 2026.

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