Hepatitis C prevalence down by 40% since 2015 in England

Keith Alcorn
Published:
11 March 2022

The prevalence of hepatitis C in England fell by almost 40% between 2015 and 2020 and deaths due to the virus fell by 35% in the same period, the UK Health Security Agency reported last week.

“In England, we are on our way to eliminating hepatitis C as the number of deaths continue to decline and direct acting antiviral drugs are available that will clear the virus in around 95% of people who complete treatment,” said Dr Helen Harris, Chief Scientist at the UK Health Security Agency (UKHSA).

The UKHSA report estimates that hepatitis C prevalence has fallen from around 129,000 in 2015 to around 81,000 in 2020 – a 37% fall in the general population.

Modelling by UKHSA estimates that 27% of the chronic infections are in people who have recently injected drugs, 62% are in those with a past drug injecting history but who are no longer injecting and 11% are in those with no history of injecting drug use.

The UKHSA modelling estimates that the prevalence of hepatitis C among people who inject drugs in England has fallen from 28% in 2015 to 17% in 2020 – a 40% decline in prevalence.

Despite a doubling in testing activity in drugs services between 2015 and 2020, UKHSA estimates that 60% of people who inject drugs living with hepatitis C in 2020 were unaware of their infection in 2020.

The reduction in prevalence has been largely achieved by increased access to treatments, with around 58,850 treatments taking place between April 2015 and the end of March 2021.

UKHSA says that there has been little change in the rate of new infections among people who inject drugs in England since 2015. The availability and uptake of harm reduction measures including sterile injecting equipment and opioid substitution treatment remain sub-optimal.

Only 62% of people who inject drugs reported that they were able to obtain adequate supplies of sterile needles and syringes and the proportion of people who reported sharing injecting equipment remained unchanged between 2015 and 2020 (20% and 24% respectively).

The re-infection rate among people who inject drugs is 11%, indicating a need for intensified harm reduction support for people during and after hepatitis C treatment.

Deaths due to advanced liver disease related to hepatitis C fell from 482 in 2015 to 314 in 2020 – exceeding the World Health Organization target for a 10% drop by 2020. New cases of hepatocellular carcinoma caused by hepatitis C fell by 21% and new cases of end-stage liver disease caused by the virus fell by 16% since 2015, suggesting that treatment is averting late-stage complications of hepatitis C as well as deaths.

Liver transplants in people with cirrhosis due to hepatitis C fell by 40% and only 6% of liver transplants carried out in England in 2020 was due to hepatitis C, compared to 12% in 2015.

Reference

UKHSA. Hepatitis C in England 2022. Working to eliminate hepatitis C as a public health problem. A short report. 3 March 2022.