Iceland is the first high-income country to meet the World Health Organization’s (WHO) targets for diagnosing and treating hepatitis C, according to a study published in The Lancet Gastroenterology & Hepatology.
Hepatitis C refers to inflammation of the liver caused by a virus. When the inflammation becomes severe, it can result in the hardening and scarring of liver tissue—which can impede the liver’s ability to function—a condition called cirrhosis. Over time, this can lead to liver cancer, liver failure and death. (For more information, check out Hep’s Introduction to Hepatitis.)
The WHO estimates that nearly 71 million people globally have chronic hep C and that a significant number will develop cirrhosis and liver cancer. The good news is that thanks to modern antiviral meds, over 95% of cases can be cured.
Based on the WHO’s 2016–2021 guidelines for ending viral hepatitis, the elimination of hepatitis C virus is defined as an 80% decrease in incidence and a 65% drop in deaths related to hep C compared with 2015 numbers. To reach these goals, the WHO set the targets for countries to diagnose 90% of hep C cases and to treat 80% of those who are diagnosed. Until now, no country had met these goals.
In Iceland, this translated to 865 people being diagnosed. Of those, 824 (95.3%) were linked to care and 717 (87%) were cured during the study period.
“This great achievement is a milestone in the effort towards global HCV elimination,” wrote Olav Dalgard, MD, PhD, of Akershus University Hospital in Norway, and colleagues, in a related Lancet editorial.
Iceland, a Nordic island nation in the North Atlantic Ocean, is the least crowded country in Europe, with a population of nearly 369,000 people. About 131,000 residents live in Reykjavik, the capital, which is located on the western side of the island.
So what’s Iceland’s secret to eliminating hep C, and can its success be replicated?
For starters, the study authors note that the country offers a national health care system and maintains a central registry for infectious diseases, which makes it easier for researchers to track data.
What’s more, Iceland operated a program from 2016 to 2019 specifically aimed at treating and preventing hep C. The nation offers harm reduction for people who inject drugs. It is also easier for people to seek treatment for addiction.
In its deep dive into the Iceland study, MedPage Today compares this to the United States, which has fragmented health insurance, a lack of harm reduction services and uneven data collection. All of which is to say that in Iceland, it’s easier to diagnose people and for them to access treatment.
In the United States, it’s estimated that about 3.5 million people are chronically infected with hep C. As Hep’s Basics section on Hepatitis C explains:
The number of new cases of HCV [hepatitis C virus] are steadily increasing, largely due to the opioid epidemic. The CDC [Centers for Disease Control and Prevention] estimates that there were 41,200 new hep C cases in 2016.
Chronic HCV infection accounted for more than 18,000 deaths in 2016 in the United States. Beginning in 2013, the number of deaths related to hepatitis C exceeded the total number of deaths from all 60 other infectious diseases combined. The World Health Organization (WHO) estimates that 71 million people are living with chronic hepatitis C infection. Worldwide, nearly 400,000 people will die as a result of hepatitis C.
For a roundup of related articles in Hep, click #Hepatitis C, where you’ll find stories such as “COVID-19 Pandemic Led to Shortfall in Hepatitis C Treatment” and “Most People With Hepatitis C Have Improved Liver Function After Treatment.”