Deaths from end-stage liver disease and liver cancer caused
by hepatitis C in the United Kingdom fell by 11% in 2017, provisional figures
from Public Health England released on 28 July show.
Most of the decline was the result of a reduction in deaths
from end-stage liver disease, not liver cancer, Public Health England says, and
took place at the same time as a 19% increase in the number of people who
received direct-acting antiviral (DAA) treatment. Public Health England says that the
United Kingdom is on track to achieve the World Health Organization’s target of
a 10% reduction in hepatitis C virus (HCV)-related mortality by 2020.
Just over 14,000 people started DAA treatment from April
2017 to March 2018, an increase of 19% on the previous year and a doubling of
the number of people receiving treatment for hepatitis C compared to 2014.
Public Heath England warns that the biggest obstacle to further increases in
the number of people accessing treatment will be the ability of the NHS, harm
reduction and drug treatment services to diagnose and link to care people with
undiagnosed hepatitis C.
- direct-acting antiviral (DAA)
A drug which prevents hepatitis C from reproducing by blocking certain steps in its lifecycle.
The Unlinked Anonymised Monitoring survey found that of
people who had hepatitis C antibodies, 72% reported ever having seen a
hepatologist and of these, 42% reported ever having been offered treatment for
The survey also found that approximately two-thirds of
people who inject drugs who have hepatitis C antibodies are aware of their
positive status. As the majority of people with hepatitis C in the United
Kingdom acquired hepatitis C through injecting drug use, this finding suggests
that the United Kingdom has already met the World Health Organization target of
50% of infections diagnosed.
However, prevention of new infections among people who
inject drugs is still sub-optimal. If prevention services are adequate and
reaching people soon after they begin injecting drugs, the proportion of people
new to injecting who have acquired hepatitis C should decline over time.
The Unlinked Anonymised Monitoring survey found no change
over the past decade in the proportion of people who recently started injecting
who tested positive (22% in 2017 compared to 24% in 2008). Surveys have also
found some evidence to suggest that the rate of new infections among people who inject drugs may
have risen since 2011. Furthermore, the survey found that two out of five
people who inject drugs reported that they did not have access to enough
sterile syringes and needles for their injecting needs in 2017.
Public Health England says that “a radical change in the
response to HCV among PWID [people who inject drugs] is required” if the United Kingdom is to achieve the
2020 World Health Organization target of a 30% reduction in new HCV infections
by 2020, let alone the target of an 80% reduction by 2030.