{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:24:00Z","timestamp":1792682640501,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:00:00Z","timestamp":1672272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003921","name":"Department of Health and Aged Care, Australian Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>The 2016 Global Health Sector Strategy (GHSS) on viral hepatitis aims to reduce new hepatitis C virus (HCV) infections by 80% by 2030, including a 30% reduction by 2020. This study aimed to estimate primary HCV incident infection among a national sample of people who inject drugs (PWID) before and after the introduction of unrestricted access to HCV direct\u2010acting antiviral (DAA) therapy via Australia's Pharmaceutical Benefits Scheme in 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A simple deterministic linkage method identified repeat respondents in serial cross\u2010sectional surveys conducted among PWID. Two separate retrospective cohorts of HCV antibody\u2010negative respondents were created, corresponding to the pre\u2010 (2010\u201315) and post\u2010 (2016\u201321) DAA time\u2010periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and Participants<\/jats:title><jats:p>This study took place in Australia. Among 757 PWID retained (376 pre\u2010DAA, 381 post\u2010DAA), more than half were male (60%), the majority were heterosexual (80%), the median age was 40\u2009years (interquartile range\u2009=\u200933\u201346\u2009years) and the predominant drugs last injected were heroin (24%), pharmaceutical opioids (27%) and methamphetamine (41%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The primary outcome was HCV seroconversion, defined as a negative HCV antibody test result followed by a positive HCV antibody result. Time to primary incident HCV infection was estimated using the person\u2010years (PY) method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>A total 97 of 376 (2010\u201315) and 41 of 381 (2016\u201321) HCV seroconversions were identified. Primary HCV incidence more than halved, from 13.6 per 100\u2009PY [95% confidence intervals (CI)\u2009=\u200911.2, 16.6] in 2010\u201315 to 5.4 per 100\u2009PY (95% CI\u2009=\u00a03.9, 7.3) in 2016\u201321. The decline was independent of observed differences in demographic and drug use characteristics over the two time\u2010periods (adjusted hazard ratio\u2009=\u00a00.47, 95% CI\u2009=\u00a00.31\u20130.69, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Australia has had a 53% reduction in primary hepatitis C virus (HCV) incidence among people who inject drugs following unrestricted availability of HCV direct acting antiviral therapy in March 2016. Given that PWID are the predominant population at risk of HCV infection in Australia, findings add to the evidence that Australia has probably met its 2020 Global Health Sector Strategy subtarget of a 30% decline in new infections.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16113","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T14:17:58Z","timestamp":1671200278000},"page":"901-911","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Incidence of primary hepatitis C virus infection among people who inject drugs in Australia pre\u2010 and post\u2010unrestricted availability of direct acting antiviral therapies"],"prefix":"10.1111","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0062-7300","authenticated-orcid":false,"given":"Jenny","family":"Iversen","sequence":"first","affiliation":[{"name":"Kirby Institute UNSW Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Handan","family":"Wand","sequence":"additional","affiliation":[{"name":"Kirby Institute UNSW Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamish","family":"McManus","sequence":"additional","affiliation":[{"name":"Kirby Institute UNSW Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4741-2622","authenticated-orcid":false,"given":"Gregory J.","family":"Dore","sequence":"additional","affiliation":[{"name":"Kirby Institute UNSW Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6020-6519","authenticated-orcid":false,"given":"Lisa","family":"Maher","sequence":"additional","affiliation":[{"name":"Kirby Institute UNSW Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,29]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Global Health Strategy on Viral Hepatitis 2016\u20132021. 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