New data from Public Health England (PHE) suggest significant reductions in the prevalence of chronic hepatitis C virus (HCV) infection in the UK.
Estimates suggest that in 2015 around 174,000 (95% credible interval [CI], 161,000-188,000) people in the UK were living with chronic HCV infection. This figure had fallen by a third to 118,000 in 2019 (95% CI, 104,000-133,000).
Injecting drug use continues to be the most important risk factor, with data from UK surveys suggesting just over half of people who inject drugs (PWID) tested positive for HCV antibody in 2019. Less than a quarter had evidence of current infection (23% in the England, Wales and Northern Ireland; 19% in Scotland).
The latest data from the Unlinked Anonymous Monitoring Survey of PWID suggest around half (51%) of participants were aware of their HCV-positive status in 2019. In the UK, overall surveys suggest that around one-third (32%) were aware of their current (HCV RNA positive) infection. Hence, the WHO target of 50 per cent of those ever infected knowing their status by 2020 has been reached in the UK.
Preliminary data suggest the incidence of HCV-related end-stage liver disease (ESLD) and hepatocellular carcinoma (HCC) fell between 2015 and 2019. Mortality data suggest a fall of 18 per cent in death registrations from HCV-related ESLD and HCC between 2015 and 2018, with provisional data suggesting a further fall of 8 per cent in 2019.
Hence, the WHO target of reducing HCV-related mortality by 10 per cent by 2020 has been exceeded more than two-fold in the UK. PHE says, based on the figures, a reduction of at least 65 per cent by 2030 seems achievable.
The fall in mortality from HCV-related ESLD and HCC observed since 2015 is consistent with increased treatment and sustained virological response rates achieved with new direct-acting antiviral drugs that have taken place over the past five years.
