The UK is on course to meet World Health Organisation goals to reduce hepatitis C-related morbidity and mortality according to an annual review of hepatitis C in the UK.
The Public Health England report ‘Hepatitis in the UK’ summarises the scale of the UK hepatitis C (HCV) challenge in 2016, to help support focused action to eliminate hepatitis C as a major public health threat by 2030.
The report states that early estimates suggest that numbers of new cases of HCV-related end-stage liver disease (ESLD) and hepatocellular carcinoma (HCC) in the UK have remained relatively stable. However, mortality data suggest a fall which may be a result of increased treatment with new direct-acting antiviral (DAA) drugs that have taken place over recent years (an increase of 46% over the last year, and of nearly 90% when compared to earlier years). As such, the World Health Organization (WHO) target of a reduction in HCV-related mortality of 10% by 2020 looks likely to be achieved, and a reduction of at least 65% by 2030 also seems achievable.
Despite this, only around one-half of people who inject drugs (PWID) sampled in UK surveys are aware of their HCV antibody positive status, and this figure has remained relatively stable at this level over the last six years. Although the WHO target of 50% of infected people in the WHO European region knowing their status by 2020 may have already been met in the UK, the authors believe that more work is needed if the target of 90% diagnosed by 2030 is to be met.
Data from UK surveys of PWID do not suggest any reduction in numbers of new HCV infections over recent years; both estimated rates of infection and prevalence of infection in recent initiates to drug use were similar in 2016 to those observed in 2011 and 2008. Moreover, the proportion of PWID reporting adequate needle/syringe provision was found to be suboptimal, with only around one half of those surveyed reporting adequate provision for their needs. These findings suggest that the WHO call to reduce new cases of chronic HCV by 30% by 2020 and 80% by 2030, represents a significant challenge for UK health services.
Overall, the authors believe that with the increasing availability of new DAA drugs, the UK is well-placed to meet WHO goals to reduce HCV-related morbidity and mortality, provided current improvements in numbers accessing treatment can be sustained in future years.