The latest ‘Hepatitis C in England 2022’ report from the UK Health Security Agency has been published, with recommendations on the actions needed to reduce incidence, increase testing, and improve linkage into care.
The latest annual report shows there has been considerable progress towards eliminating hepatitis C as a public health problem by 2030 in England, with data showing that deaths from hepatitis C have fallen by 35% between 2015 and 2020. The report also details many other achievements of the drive to eliminate hepatitis C in England, including:
Estimated prevalence of chronic hepatitis C in England has continued to decline to around 81,000 in 2020 (compared to 129,000 in 2015) – a 37% fall in the general population.
Provisional data suggests that there has been a 40% decline in hepatitis C infection among people who inject drugs.
Deaths due to advanced liver disease related to hepatitis C have also fallen, from 482 in 2015 to 314 in 2020 – exceeding the World Health Organization target for a 10% drop by 2020.
Hepatitis C virus (HCV) is a bloodborne virus that can cause life-threatening liver disease, including cancer. However, those infected often have no symptoms until many years later when their liver has been badly damaged.
When symptoms do occur, they can often be non-specific, like tiredness or loss of appetite, and be dismissed or mistaken for other conditions.
The virus is spread through blood-to-blood contact, most commonly in the UK by sharing needles contaminated with the virus – but even sharing razors or toothbrushes with an infected person could pass on the virus.
Modelling indicates that, of the 81,000 people estimated to have this chronic infection in England, around:
27% of the chronic infections are in people who have recently injected drugs
62% are in those with a past drug injecting history but who are no longer injecting
11% are in those with no history of injecting drug use
The reduction in prevalence has been largely achieved by increased access to treatments, with around 58,850 treatments taking place between April 2015 and the end of March 2021.
Importantly, treatment can cure – 95% of people who complete treatment clear the virus.
While there has been huge progress over recent years in the diagnosis and treatment of hepatitis, challenges remain. While effective treatments are available, we need to stop people becoming infected in the first place if we are to eliminate hepatitis C.
Provisional data from a national survey suggested that more than half (60%) of people who inject drugs may be unaware of their chronic HCV infection, increasing the chance that they could unknowingly pass the virus to others.
Prevention, through sustained harm reduction services, and early diagnosis are critical, especially since preliminary data indicated that around 8% of people (11% in those with a known history of injecting drugs) may go on to be reinfected after successful treatment.
Dr Helen Harris, Clinical Scientist at the UKHSA, said:
“In England, we are on our way to eliminating hepatitis C as the number of deaths continue to decline and direct acting antiviral drugs are available that will clear the virus in around 95% of people who complete treatment.
“But many people remain undiagnosed, often because they have no symptoms or are unaware that they have ever been at risk. If you have ever injected drugs – even if it happened only once or years ago – you could be at risk of hepatitis C. If you think you could be at risk, speak to your GP and get a free test.”
Dr Jenny Harries, the CEO of UKHSA, said:
“It is really encouraging to see cases of chronic hepatitis C declining in England. We must keep pushing this trend downwards – too many people continue to be affected by this debilitating but preventable condition.
“Hepatitis C treatment has improved dramatically over recent years. Latest treatments are effective and well tolerated, so if you have been at risk or tested positive in the past don’t delay visiting your GP.
“If you think your loved ones may have been at risk, please encourage them to get tested and treated.”
Sajid Javid, Health and Social Care Secretary, said:
“It is fantastic to see the significant progress that has been made in eliminating hepatitis C in England. Deaths and prevalence of the virus have fallen consistently thanks to improvements in diagnosis, access to treatments and the hard work of the NHS.
“This is another example of the UK being at the forefront of tackling serious diseases. We are on track to eliminate this virus by 2030 and I urge anyone who may be at risk to get tested as soon as possible.”
Brendon, 46 years old, a former hepatitis C patient based in England:
“I was concerned about why I was lethargic all the time, so when people from the Hepatitis C trust spoke to me, they encouraged me to get tested for hepatitis C. I found out that I’ve got it.
“At first, I didn’t want any treatment because my friends and a lot of people my age believe the treatment is what it was 20 years ago. I didn’t realise there is a much better treatment nowadays! I found it incredibly easy: one tablet a day for 90 days. And I was clear after that.
“People need to get comfortable about getting tested. You might have got hepatitis C from using drugs or you might have got it from sharing a razor to shave. You never know. There should be no stigma about getting tested.”
Read the full ‘Hepatitis C in England 2022’ report here.
People who are not sure whether they are at risk can answer some short questions to find out whether they might have been exposed to the virus and should seek a test, or speak to their GP and get tested.
For anyone wishing to access confidential support, The Hepatitis C Trust offers a confidential service staffed by people who have personal experience of hepatitis C. For any help or support please call 020 7089 6221 or email email@example.com.