Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate Professor Matthew Akiyama, Albert Einstein College of Medicine, USA
- Second opponent: Chief Physician Anne Øvrehus, Odense University Hospital, Denmark
- Third member and chair of the evaluation committee: Professor Anne Ma Dyrhol-Riise, University of Oslo
Chair of the Defence
Associate Professor Dag Henrik Reikvam, University of Oslo
Principal Supervisor
Associate Professor Håvard Midgard, Oslo University Hospital
Summary
Two-thirds of the hepatitis C virus (HCV) disease burden in Western Europe can be attributed to injecting drug use. Norway has committed to the World Health Organization’s (WHO) global strategy for the elimination of viral hepatitis as a public health concern by 2030, but people who inject drugs (PWID) are not sufficiently reached with HCV treatment and new models of care are needed.
The overall aim of this thesis was to increase the knowledge about HCV infection among PWID by presenting generalizable data on key aspects, in order to inform HCV elimination strategies locally and internationally.
Study 1 was a registry-based study that assessed treatment uptake among PWID in Oslo and found that treatment rates among PWID have increased in Norway after the arrival of direct-acting antivirals, but that women and those not receiving opioid agonist treatment were less likely to receive HCV treatment.
Study 2 was a stepped-wedge cluster randomized controlled trial, assessing immediate HCV treatment among hospitalized PWID compared to standard of care. The study found that immediate treatment was superior to standard of care in terms of treatment initiation and completion. Study 3 was a follow-up study of study 2, and found that time to virologic cure was shorter among intervention participants compared to standard of care, and that complete dispension from the pharmacy could be used as a measure of cure. The study also found reinfection rates similar to findings from previous studies in Norway, which should be of concern.
Collectively, these findings are highly relevant for future elimination efforts, both nationally and internationally.
Additional information
Contact the research support staff.