Laboratory-confirmed new diagnoses of hepatitis C infection (HCV) reported in England rose to 10,873 cases in 2012, up by more than one third from the 7,882 cases reported in 2010 – when statutory notification by diagnostic laboratories was first introduced. London accounted for 26 per cent of all cases reported in England in 2012, almost treble – at 2,844 cases – the 954 reported in London in 2010. These are among the conclusions of the annual hepatitis C report published by Public Health England (PHE) ahead of World Hepatitis Day on Sunday 28 July [1,2].
The report is the eighth for England, and the fifth also to present consolidated data for the UK as a whole. The main chapters describe: the scale of the UK problem; prevention; diagnosis, testing and awareness of infection; and treatment and care in England, Scotland, Wales and Northern Ireland, respectively. Data are also presented on testing and diagnosis in respect of particular groups (people who inject drugs, prison populations, black and minority ethnic populations and blood donors).
Across the UK more than 215,000 individuals are thought to be chronically infected with hepatitis C. In England, around 160,000 people are living with chronic infection, the report confirms, many of whom are unaware of their infection. Over the past 15 years, hospital admissions for hepatitis C-related end stage liver disease and liver cancer in England have increased from 574 in 1998 to 2,266 in 2012, while deaths have risen from 115 in 1998 to 326 in 2012.
Antiviral therapies exist that will clear the virus in most cases, yet only around three per cent of the chronically infected population in England access them each year. Preliminary results from statistical models presented in the report suggest that cases of hepatitis C-related, end-stage liver disease, and the number of liver cancer patients, could be substantially reduced by increasing access to treatment.
The greatest risk of hepatitis C infection is associated with sharing equipment for injecting drugs. Data from the Unlinked Anonymous Monitoring (UAM) survey of people who inject drugs suggest that levels of infection in this group remained high in 2012, with around half of those surveyed in England being infected .
PHE is encouraging local authorities and NHS colleagues to absorb the recommendations in this report and take local action to drive improvements in the prevention, diagnosis and treatment of hepatitis C infection.
1. PHE, HP Scotland PH Wales, HSC (Northern Ireland), July 2012. Hepatitis in the UK (2013 report). Downloadable from the legacy HPA website: Publications › Infectious diseases › Bloodborne infections › Hepatitis C in the UK › Hepatitis C in the UK: 2013 report.
2. “Hepatitis C diagnoses rise by a third in England”, PHE news release, 25 July 2013.