PHE and NHS England have launched a national exercise to identify and treat patients who have been previously diagnosed with hepatitis C. In recent years new, potentially curative treatments have been developed for hepatitis C, but tens of thousands of people who were diagnosed in the past may not have accessed them.
A new report, the first of its kind, by PHE shows more than 24,500 people in England have accessed new hepatitis C treatments in the last three years. The new report also established that 95% of people who received and completed hepatitis C treatment have been cured of the serious and potentially life-threatening infection in the last three years. This is primarily due to effective new direct acting antiviral medication which became available on the NHS in 2015.
A large majority of those treated (70%) report injecting drugs as their likely risk for acquiring hepatitis C. It is reassuring that treatment is reaching other groups at increased risk of infection, as 11% of those receiving treatment were of Asian ethnicity and almost a third were born outside the UK.
PHE is urging those who may have been at risk of contracting hepatitis C, especially if they have injected drugs, even if only once or in the past, to get tested, as often people with the infection do not have any specific symptoms until their liver has been significantly damaged. Many people do not know they have the infection, and when symptoms do occur they are often mistaken for other conditions, resulting in many people remaining undiagnosed.
Dr Mamoona Tahir, PHE West Midlands Health Protection Consultant leading on blood borne viruses, said: “In the West Midlands region we have almost 4,900 people who were previously diagnosed with hepatitis C but who we believe are not receiving treatment. A significant number of these people are in vulnerable groups such as those who have been in the prison system, people experiencing homelessness, injecting drug users, and people from the migrant population. These people are our primary focus, as they may not be aware that there are now effective treatments available on the NHS which act quickly and do not have severe side effects, also they are less likely to engage with treatment on their own. NHS England and PHE are working towards the goal of hepatitis C elimination by 2025. The West Midlands NHS Operational Delivery Network (ODN) is one of 22 such networks across England, with public health partners working together to coordinate patient treatment pathways between providers to ensure access to specialist resources and expertise. Through this coordinated approach we hope to contact people with hepatitis C and get them the treatment that they need.”
Dr Helen Harris, Clinical Scientist at PHE, said: “Hepatitis C is a serious infection and therefore we are delighted to see that at least 9 in 10 people who have completed treatment in England have now been cured. This is fantastic news, and a step towards eliminating hepatitis as a major public health threat by 2030, as knowing the numbers accessing treatment is vital to tackling this infection. We will however continue in our endeavours to find and treat everyone who is living with hepatitis C. If you have been at risk of contracting hepatitis C, particularly through injecting drugs, even if you injected only once or in the past, then I urge you to get tested to see if you would benefit from these new, effective treatments.”
Dr Graham Foster, NHS England’s Hepatitis C clinical chair, said: “This dramatic NHS progress in treating hepatitis C over the past few years is one of the biggest but least acknowledged NHS success stories. By investing several hundred million pounds, NHS England has helped transform the lives of thousands of people, and with fair pricing from the drug companies the NHS has a real prospect of eliminating hepatitis C altogether.”
Rachel Halford, Chief Executive of The Hepatitis C Trust, said: “We have an extraordinary opportunity to eliminate hepatitis C in the near future if we can ensure all those living with the virus are treated with simple, curative treatments. We know that many people who were previously diagnosed were never treated, and might be unaware that new treatments are now available. This re-engagement exercise will help ensure everything possible is being done to find, treat, and cure those infected and move towards elimination by 2030."
Two years ago, the UK government committed to a joint ambition with 193 other countries to eliminate the disease as a major public health threat by 2030. As well as testing and treatment, prevention through needle and syringe exchange services and opiate substitution therapies need to be sustained to achieve and maintain elimination.
If untreated, infection with hepatitis C can lead to liver damage, cancer and even death. Hepatitis C is spread through blood-to-blood contact, most commonly in England by sharing needles contaminated with the virus, but even sharing razors or toothbrushes with an infected person could pass on the virus.
If someone thinks they have been at-risk of catching hepatitis C, PHE recommend they get tested at their local GP practice, sexual health or community drug services. If people aren’t sure about whether they are at risk, they can take a short quiz on the Hepatitis C Trust website to find out if they should get tested.
