Public Health England report shows that although testing increases, rates of new infection remain the same

The key national report on the UK’s progress towards eliminating hepatitis C has been published by Public Health England. The annual report, ‘Hepatitis C in the UK: 2019’, sets out that although a lot has been achieved towards the World Health Organisation’s target of eliminating hepatitis C as a major public health threat by 2030, there is still much to do.

There is little evidence of any fall in the number of new infections, though the rates of people accessing treatment is on a positive increase. The report therefore calls for a ‘radical change’ in the health service’s approach to hepatitis C among people who inject drugs. Only 60% of those surveyed who inject psychoactive drugs reported that they had adequate needle and syringe provision in 2017. Although the level of equipment-sharing has reduced since 2007, there is no evidence of any decline over the last 5 years.

Encouragingly, testing rates have risen in some at-risk groups, such as people in prison and the South Asian and Eastern European populations. Opt-out blood-borne virus testing is now fully implemented across the prison estate, with three-quarters (75%) of new receptions offered testing, and one quarter (26%) taking this up. This indicates an increasing awareness of HCV in prisons with significant increases in testing, including DBS testing.

The Hepatitis C Trust is also praised for continuing to raise awareness of hepatitis C among key risk groups, providing a confidential helpline, and developing and implementing patient-centred interventions.

It is particularly notable that the UK achieved the WHO target to reduce hepatitis C-related mortality by 10% by 2020 three years early, in part due to new direct-acting antivirals with their higher success rate and shorter treatment terms. England has also met the WHO target of 50% of people living with the virus being diagnosed by 2020, but the report emphasises that more must be done if the target of 90% diagnosed by 2030 is to be met.

Rachel Halford, Chief Executive of The Hepatitis C Trust, said: "It is encouraging to see deaths from hepatitis C-related liver disease falling as more patients access DAA treatments. It is, however,  essential that we work to  find the estimated 40-50% of patients who remain undiagnosed and support them to access treatment services - to stop unnecessary deaths and ensure we reach elimination of hepatitis C by 2030 at the latest  Anyone who thinks they may been at risk of transmission should get tested - The Hepatitis C Trust website hosts a simple quiz which can tell you whether you may have been at risk."

The full Hepatitis C in England report can be read here