HCV incidence and prevalence trends among people who use drugs in France 2004 to 2023
Abstract
Hepatitis C virus (HCV) remains a key public health challenge, particularly among people who use and inject drugs (PWUD, PWID). While direct-acting antivirals (DAA) have revolutionized HCV treatment, meeting the WHO’s 2030 elimination target requires accurate estimation of incidence and prevalence to guide prevention and care. We analyze cross-sectional surveys conducted in France in 2004, 2013, and 2023, recruiting PWUD at harm reduction services and collecting behavioral and biological data. We estimate age-and time-dependent prevalence of HCV antibodies and HCV RNA using multivariate regression models while incidence was estimated from two-state transmission models. The demographic profile of PWUD has aged over time (mean age 35 years in 2004 vs. 44 in 2023) while injection prevalence remained stable (61.7% in 2023). Between 2013 and 2023, HCV burden declined substantially: HCV RNA prevalence fell from 19.4% (95% CI 16.3–23.0) to 9.5% (7.2–12.3) among all PWUD, and from 29.6% to 14.5% among PWID. Incidence among PWID decreased from 6.5 (4.1–8.0) to 2.4 (1.4–4.2) per 100 person-years. These reductions likely reflect the combined impact of DAA scale-up and harm reduction policies, marking substantial progress toward elimination targets. However, ongoing transmission highlights persistent barriers requiring targeted public health actions.
Related
- LONG-TERM TRENDS IN HEPATITIS B AND C PREVALENCE, INCIDENCE, AND FORCE OF INFECTION AMONG BLOOD DONORS IN BRAZIL
- Global trends in the burden of malaria: mapping the prevalence, incidence and mortality of Plasmodium falciparum and Plasmodium vivax in the era of climate change and emerging drug resistance.
- International trends in clozapine utilisation prevalence in adults, adolescents and older people: An observational study in 42 countries between 2015 and 2024
- Incidence and prevalence of acquired brain injury in children and young people globally: A systematic review and meta-analysis protocol
- High Initiation but Suboptimal Completion of Tuberculosis-Preventive Treatment Among People Living With HIV on Antiretroviral Therapy, Persistent Tuberculosis Incidence, and Programmatic Implications: Findings From a 2-Year Multicountry Cohort Study
BibTeX
@article{sabbatini2026incidence,
title = {{HCV incidence and prevalence trends among people who use drugs in France 2004 to 2023}},
author = {Chiara E. Sabbatini and Yann Le Strat and Christophe Bonaldi and Cécile Brouard and Martin Audran and Leïla Saboni and Jean-Baptiste Richard and Amélie David and Catherine Gaudy-Graffin and Stéphane Chevaliez and Francis Barin and Karl Stefic and Marie Jauffret-Roustide},
journal = {Nature Communications},
year = {2026},
month = oct,
doi = {10.1038/s41467-026-78598-3},
url = {https://www.nature.com/articles/s41467-026-78598-3},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - HCV incidence and prevalence trends among people who use drugs in France 2004 to 2023
AU - Chiara E. Sabbatini
AU - Yann Le Strat
AU - Christophe Bonaldi
AU - Cécile Brouard
AU - Martin Audran
AU - Leïla Saboni
AU - Jean-Baptiste Richard
AU - Amélie David
AU - Catherine Gaudy-Graffin
AU - Stéphane Chevaliez
AU - Francis Barin
AU - Karl Stefic
AU - Marie Jauffret-Roustide
PY - 2026
DA - 2026/10/11
JO - Nature Communications
DO - 10.1038/s41467-026-78598-3
UR - https://www.nature.com/articles/s41467-026-78598-3
AB - Hepatitis C virus (HCV) remains a key public health challenge, particularly among people who use and inject drugs (PWUD, PWID). While direct-acting antivirals (DAA) have revolutionized HCV treatment, meeting the WHO’s 2030 elimination target requires accurate estimation of incidence and prevalence to guide prevention and care. We analyze cross-sectional surveys conducted in France in 2004, 2013, and 2023, recruiting PWUD at harm reduction services and collecting behavioral and biological data. We estimate age-and time-dependent prevalence of HCV antibodies and HCV RNA using multivariate regression models while incidence was estimated from two-state transmission models. The demographic profile of PWUD has aged over time (mean age 35 years in 2004 vs. 44 in 2023) while injection prevalence remained stable (61.7% in 2023). Between 2013 and 2023, HCV burden declined substantially: HCV RNA prevalence fell from 19.4% (95% CI 16.3–23.0) to 9.5% (7.2–12.3) among all PWUD, and from 29.6% to 14.5% among PWID. Incidence among PWID decreased from 6.5 (4.1–8.0) to 2.4 (1.4–4.2) per 100 person-years. These reductions likely reflect the combined impact of DAA scale-up and harm reduction policies, marking substantial progress toward elimination targets. However, ongoing transmission highlights persistent barriers requiring targeted public health actions.
SN - 2041-1723
ER -