Hepatitis C in London annual report

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London accounts for nearly a third of all newly diagnosed cases of hepatitis C reported in England, with 3,079 new laboratory reports of confirmed diagnoses reported in 2013, a rise of 12% since 2012. London also has the second highest rate of diagnosis per head of population, after Greater Manchester.

In terms of burden of disease resulting from chronic infection, London is among three regions of England with very high rates of hepatitis-related, end-stage liver disease (ESLD) and hepatocellular carcinoma (HCC). In 2013, nearly 2,000 people in London were admitted to hospital with a diagnosis of hepatitis C, and hepatitis C was the primary indication for just under a quarter of first liver transplants in London.

Nevertheless, there is some evidence that the trend in new infections (nationally and in London) is stable or declining in England and that the steady increase in the annual number of laboratory-confirmed new diagnoses of recent years reflects improved ascertainment (including higher levels of testing and reporting of laboratory results).

These are among the conclusions of PHE’s latest annual report for London [1] that presents epidemiological data, an assessment of the burden of disease and, in particular, describes progress made in preventing infection and improving rates of testing among the main risk groups – principally people who inject drugs (PWID) in the general population and in prisons (accounting for more than 90% of laboratory -confirmed cases in England).

It is estimated that over half of all PWID in London have hepatitis C (59%). In the past 10 years, sex between men has also emerged as an important route of transmission. Individuals originating from south Asia, where the prevalence of hepatitis C is high, are also particularly at risk.

The London report includes specific recommendations for different groups of health professionals: GPs, directors of public health, local authorities and commissioners of drug treatment services, Clinical Commissioning Groups (CCGs), NHS England, PHE London Centre and Region, laboratories, providers of prison health services, providers of drug treatment services, and providers of hepatitis C treatment services.