Massive progress in Hepatitis C elimination in England thanks to NHS efforts

The National Health Service (NHS) England played a crucial role in this triumph, having treated over 80,000 individuals since 2015 as part of its ambitious national elimination programme.

Impressively, this means that more people have now been successfully treated and cured of the virus than the number of people still requiring treatment. Notably, over 80 per cent of those treated were from the most deprived areas in England, highlighting the programme's vital contribution to reducing health disparities.

The effort to eliminate hepatitis C and its counterpart hepatitis B has been a top priority for both UKHSA and NHS England. Their aim is to align with the World Health Organisation's elimination target, which seeks to combat these infectious diseases globally by 2030.

To achieve this, UKHSA recently launched its comprehensive strategy, encompassing the mission to prepare for, prevent and respond to health threats, ultimately safeguarding lives and livelihoods.

Hepatitis C is a blood-borne virus that can lead to severe liver diseases, including cancer, often remaining asymptomatic until extensive liver damage has occurred. The virus primarily spreads through blood-to-blood contact, frequently through the sharing of contaminated needles among drug users.

Additionally, sharing personal items such as razors or toothbrushes with an infected individual can also transmit the virus. People born in countries with higher hepatitis C prevalence and those who have undergone medical treatments abroad are at an increased risk.

While significant progress has been made in the diagnosis and treatment of hepatitis C, certain challenges persist. The latest data from UKHSA reveals that a small but notable number of individuals who were successfully treated have experienced re-infection, underscoring the importance of maintaining robust prevention services.

UKHSA is actively collaborating with partners to prevent, detect and treat the infection. One initiative involves working with regional operational delivery networks (ODNs) to streamline data and concentrate efforts on identifying and treating the remaining individuals in need.

Dr Sema Mandal, Deputy Director of Blood Borne Viruses at UKHSA, emphasised the necessity of early identification of infected individuals to stay on track with the elimination target. Many cases go undiagnosed due to the absence of symptoms or lack of awareness about potential risk factors. Dr Mandal urged individuals who may have ever injected drugs, even if it was only once or years ago, to consider testing for hepatitis C. Testing can be done through one's GP or using at-home test kits.

As part of its elimination programme, NHS England has expanded testing options to locate remaining cases of hepatitis C across all settings. Earlier this year, a free and confidential online testing portal was introduced, enabling individuals to order at-home testing kits.

Over 4,500 people have already availed themselves of this convenient option, facilitating testing for those who might not have had access to traditional healthcare service providers.

Anyone in England concerned about potential hepatitis C exposure can order a home test kit or consult their GP, local pharmacist, or specialist drug and alcohol service for support.

Professor Sir Stephen Powis, NHS National Medical Director, expressed his delight at the remarkable progress made in treating over 80,000 individuals as part of the hepatitis C elimination programme. With a simple and highly effective treatment, individuals are usually cleared of the virus within three to four months. Professor Powis emphasised the ease of testing and treatment availability, urging those at risk to seek testing and treatment without delay.

Health Minister Will Quince praised the progress, stating that England is on track to be one of the first countries in the world to eliminate hepatitis C. He highlighted the consistent decline in deaths and prevalence of the virus, which has been attributed to improvements in diagnosis and treatment accessibility.

Quince reiterated the government's commitment to promptly procuring the best treatments and addressing inequalities through targeted screening to meet the World Health Organisation's elimination goal by 2030.

Rachel Halford, CEO of The Hepatitis C Trust, acknowledged the extraordinary progress made toward hepatitis C elimination in England.

She emphasised the importance of collaboration between affected communities, the government and healthcare professionals and urged continuous efforts to ensure the elimination target is met. Halford stressed that hepatitis C can go undetected for many years, leading to life-threatening liver damage, and encouraged everyone at risk to get tested, treated and cured.

UKHSA's comprehensive strategy for hepatitis C elimination includes enhancing the evidence base, surveillance and evaluation of public health interventions on blood-borne viruses. The goal is to reduce new infections and prevent avoidable illnesses and deaths.

Additionally, the agency aims to understand why some people acquire new infections or reinfections and are not retained in care, in order to respond to outbreaks more effectively and optimise initiatives that reduce transmission. The strategy also focuses on reducing health inequalities around blood-borne viruses by identifying and reaching undiagnosed and under-engaged populations and addressing gaps in access and care through targeted testing and treatment initiatives.

With the collective efforts of healthcare professionals, policymakers and the public, England is rapidly advancing towards its goal of eliminating hepatitis C as a public health concern, setting an example for other countries in the global fight against this infectious disease.