The latest annual report from the UK Health Security Agency (UKHSA) shows there has been considerable progress towards eliminating hepatitis C as a public health problem by 2030 in England.
The data shows the 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 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. 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.”
