40 ára afmælisráðstefna SÁÁ: Treatment as prevention for hepatitis C (TraP HepC): A nationwide elimination program in Iceland
Sigurður Ólafsson, MD, FACP, Director of Hepatology, Division of Gastroenterology, Department of Medicine Landspitali University Hospital
Hepatitis C virus (HCV) infection is one of the leading causes of cirrhosis and hepatocellular carcinoma worldwide. Injection drug use is the main mode of transmission in developed countries, accounting for the majority of new and existing infections. In recent years a growing number of new direct acting antiviral (DAA) agents have become available, revolutionizing the field of treatment for HCV. However treatment uptake remains low in most countries, partly because of high drug costs, particularly when they initially came on to the market, but also because of barriers to care among people who inject drugs (PWID). A nationwide program for the treatment of all patients infected with HCV was launched in Iceland in January 2016. By providing universal access to DAAs to the entire patient population, the key aim of the project is to offer a cure to patients and thus reduce the long-term sequelae of chronic hepatitis C. The second key aim is to reduce domestic incidence of HCV in the population by 80%, ahead of the WHO elimination goals. The vast majority of cases will be treated within 36-months from the launch of the project, during 2016-2018. Emphasis is placed on early case finding and treatment of patients at high risk for transmitting HCV, i.e. PWID, as well as patients with advanced liver disease. In addition to treatment scale up, the project also entails intensification of harm reduction efforts, improved access to diagnostic tests, as well as educational campaigns to curtail spread, facilitate early detection, and improve linkage to care. With these efforts Iceland is likely to achieve the WHO hepatitis C elimination goals well before 2030. Addiction medicine and Vogur Hospital, SÁÁ, play one of the key roles in this program.
Sigurdur Olafsson is Associate Professor of Medicine at the University of Iceland Faculty of Medicine and Director of Hepatology in the Division of Gastroenterology, Landspitali – The National University Hospital of Iceland. Dr. Olafsson received his Medical Degree from the University of Iceland in 1985 and undertook early postgraduate training at the University Hospital in Reykjavik. Dr. Olafsson continued his postgraduate education in the US, where he completed a residency in Internal Medicine at Cleveland Metropolitan General Hospital and Case Western Reserve University in 1991 and a fellowship in gastroenterology and hepatology at Northwestern Memorial Hospital and Northwestern University School of Medicine in Chicago in 1994. Dr. Olafsson then returned to Iceland where he was a Consultant at the Akranes Hospital from 1994-2003 and Consultant in gastroenterology and hepatology at the University Hospital in Reykjavik since 1998. Dr Olafsson was named Associate Professor of Medicine at the University of Iceland in 2009.
Dr. Olafsson is currently the Treasurer of the Icelandic Society of Internal Medicine. He has also been elected Fellow of the American College of Physicians and Honorary Fellow of the European Federation of Internal Medicine.
Dr. Olafsson currently leads a nationwide hepatitis C treatment program in Iceland.