Abstract: Background and aims: The overall prevalence of anti-HCV in the ETOHN cohort (EC; general population of Cantabria) in 2016 was 1.1%, with a prevalence of viremia of 0.34%. It is likely that the universal treatment of patients with HCV hepatitis in recent years has brought us closer to its elimination in our region. Aims: 1) To determine the prevalence of seropositivity and chronic HCV infection and to analyze the associated factors in the Cantabria Cohort (CC, CohorteCantabria) in the year 2022. 2) To determine the incidence of new cases of hepatitis C and analyze the associated factors. 3) To compare these results with those obtained in the EC (year 2016). Method: 1) CC: Cross-sectional study in the general population participating in the CC project, which includes volunteers and random sampling of the entire population of Cantabria between 40 and 70 years old. In the blood sample at baseline, HCV antibody (anti-HCV) detection was carried out and, in positive cases, automatic viraemia quantification was performed. The volunteers included in this cohort between March 2021 and March 2022 were analyzed. 2) EC: Population-based cross-sectional epidemiological study, carried out during the years 2015?2016, exclusively including the population of the Santander node. 3) Analysis of the set of all viremic subjects in Cantabria in the same period. Results: CC: 11,094 subjects were included (4,355 from 40 to 49 years; 3,823 from 50 to 59 years and 2,916 from 60 to 69 years), 38% male. Anti-HCV was detected in 102 cases (0.9% prevalence). Excluding 10 cases pending definitive study, positive HCV-RNA was detected only in 7 cases (0.06% prevalence). The remaining anti-HCV positive subjects are divided into 18 cases with spontaneous clearance and 77 cases with SVR. The total incidence of viremic patients of the entire population of Cantabria (585,000 subjects) in this period was calculated (112 cases, 19 cases/100,000 inhabitants/ year), of which 65 (58%) were previously known, accordingly the incidence rate of new cases was 10 cases/100,000 inhabitants/year. When we compare these results with those obtained in the EC (previously published, doi: 10.1111/jvh.13238) we observed a lower prevalence (1.1% vs 0.9%, p < 0.001) and a great decrease in the viraemia rate among seropositives in CC (34% vs 6%, p < 0.0001). The CC showed 11.8% (1310) of volunteers with elevated transaminases levels, compared to 17.8% of the population analyzed in the EC. Conclusion: The current prevalence (2022) of anti-HCV was slightly lower than that reported previously (2016) in the same population; In addition, and as the most outstanding fact of the study, the prevalence of viraemia was less than 10% of the seropositives. This fact, associated with an incidence of 10 new-cases/100,000 inhab./ year, places Cantabria close to the goals set by the WHO for the definition of HCV elimination in a certain geographical region.

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