New NHS England and Public Health England (PHE) figures show that 1027 individuals in the East of England tested positive for antibodies to HCV and/or HCV RNA in 2017. The number of reports increased steadily between 2013 and 2016 but decreased slightly from 2016 to 2017.
From 2013 to 2015, hospital admissions for HCV-related end-stage liver disease (ESLD) and hepatocellular carcinoma (HCC) in the East of England remained relatively stable but declined sharply into 2016. PHE theorises that this decline is probably due to reporting delay. Data for hospital admissions for 2017 are not currently available.
HCV was the primary indication for 12 per cent of liver transplants in the region from 2013 to 2017. The East of England has one of the lowest death rates in England from ESLD or HCC in individuals who have HCV mentioned on their death certificate.
Injecting drug use remains the most important risk factor for HCV infection. In the East of England, PHE’s Unlinked Anonymous Monitoring (UAM) Survey estimated the prevalence of HCV in persons who inject drugs (PWID) to be 45 per cent in 2017.
It is estimated that there are tens of thousands of people currently living with diagnosed HCV who are not in contact with treatment services.
NHS England and PHE say: “With the advances in treatment, reductions in HCV morbidity and mortality should be possible. However, reducing the number of new infections among those most at risk is likely to prove more challenging.”
PHE and NHS England hope that the patient re-engagement exercise launched last year will help to identify people previously diagnosed with HCV, allowing them to access appropriate treatment.