Impact of Direct‐Acting Antivirals Availability on Hepatitis C‐Related Hospitalisations After Eight Years of the Strategic Plan for Tackling Hepatitis C Implementation in Spain

The Strategic Plan for Tackling Hepatitis C launched by the Ministry of Health in 2015 led to an important nationwide decrease in chronic hepatitis C-related hospitalisation rates by 2018 (25.8% of decrease compared to 2014 rates). This work aims to actualize the results on hepatitis C hospitalisation burden in Spain until 2023. Chronic HCV-related hospitalisation discharges from 2014 to 2023 were obtained from the Registry of Specialised Health Activity. A descriptive analysis of the hospitalisations was performed. All chronic, advanced liver disease (AdLD), and non-AdLD (N-AdLD) hospitalisation rates (HRs) were calculated at national and regional level. Hospitalisation rate ratios using 2014 as reference year were calculated using a Poisson model. From 2014 to 2023 there were 374,222 chronic HCV-related hospitalisations: 267,920 (71.6%) with N-AdLD and 106,302 (28.4%) with AdLD. Overall in-hospital fatality rate was 6.8%. In 2023, compared to 2014, national HRs decreased 49.7% (95% CI: 49.0% to 50.4%) for all chronic, 43.3% (95% CI: 42.4% to 44.3%) for N-AdLD and 62.6% (95% CI: 61.5% to 63.6%) for AdLD. At regional level, 10/19 Spanish regions achieved a decrease in the HRs of > 40%-60% and 1/19 of > 60%-80% for N-AdLD. For AdLD, 14/19 of the regions achieved a decrease in the HRs of > 60% (one of them, Ceuta, > 80% of decrease) and 3/19 a decrease of > 40%-60%. Following the implementation of the Strategic Plan, the hospital burden due to chronic HCV has continuously decreased in Spain. By 2023, the hospitalisation rate for chronic cases has been reduced to half.