The UK Health Security Agency (UKHSA) has launched genomic
surveillance of hepatitis C virus (HCV) in a bid to monitor drug
resistance, tackle harder to treat viral strains, and detect
outbreaks sooner. The technology will allow a better
understanding of treatment outcomes to inform national treatment
programmes as well as transmission patterns to stop ongoing
transmissions among populations at risk of hepatitis C.
New data published
today by the UKHSA show a major drop in chronic HCVinfections across England. The
number of people aged over 16 with chronic HCV has fallen by 56.7% since 2015,
from an estimated 129,400 to 55,900 in 2023.
The decline in people living with the virus is largely due to the
efforts of NHS England's HCV Elimination Programme, with
increased testing and improved access to Direct Acting Antivirals
(DAAs) with
improved treatment efficacy since 2015. Hepatitis C-related
mortality is now at its lowest in nearly 10 years, falling from
0.69 per 100,000 people in 2015 to 0.41 per 100,000 in 2023.
However, resistance to antivirals does emerge. Data from 2023
showed that 5% of subtype 1a samples from patients who have not
had treatment before, were resistant to one class of HCV antiviral drugs. In addition, some
HCVsubtypes that are
prevalent in Asia and sub-Saharan Africa, but are also found in
this country, show inherent resistance to some DAAs.
In order to monitor this situation more closely, UKHSA has
established a genomics surveillance programme, to look for
genetic markers of drug resistance.
Dr Monica Desai, Hepatitis C lead at UKHSA, said:
Early diagnosis and effective anti-viral drugs have played a huge
part in driving down hepatitis C in this country, but we must
always be alert to the emergence of resistance putting progress
in jeopardy. Through our genomic surveillance programme we can
monitor changes in how the virus is responding to treatment and
more quickly respond if resistance increases.
Many people live with hepatitis C without knowing it, as symptoms
often don't show for years. But early diagnosis means faster
access to highly effective treatments that prevent liver damage.
If you have ever injected drugs - even once, many years ago -
please get tested. Testing is quick, free, and available both
through your GP and online. You should also get tested if you
have had medical procedures abroad or unprotected sex with
someone who might have hepatitis C.
HCV is a bloodborne
virus that can cause life-threatening liver disease and cancer.
However, those infected often have no symptoms until many years
later when their liver has been badly damaged. When symptoms do
occur, they can often be non-specific, such as tiredness or loss
of appetite, and be dismissed or mistaken for other conditions.
Early detection and treatment can also reduce the risk of passing
the virus onto others.
The virus spreads through blood-to-blood contact, most commonly
in the UK by sharing needles, syringes or other non-sterile
injecting equipment.
Other people at risk
of acquiring the infection are those who:
- have been in prison
- have experienced homelessness
- have had a medical procedure or tattoo abroad
- are from a country with a higher prevalence
of HCV
- those who received a blood transfusion or a blood product
before widespread screening was introduced in the UK
NHS England launched a home testing
service in May 2023, with over 60,000 people ordering tests
so far. The testing service is available to everyone over the age
of 18 in England.
Professor Sir Stephen Powis, National Medical Director at NHS
England, said:
Eliminating hepatitis C in this country will represent one of the
most significant health achievements of our time.
The NHS England elimination programme has already made incredible
progress in driving down the numbers of people living with the
virus through the provision of more than 100,000 treatments since
2015 – with 8 in 10 treatments going to the most deprived people
in the country, tackling health inequalities in the process.
The mission now is to sustain these achievements through testing
programmes that will identify the remaining people living with
hepatitis C, and this last push will require the strengths of all
our partners across government, industry and the charity sector.
You can take a quiz to find out
whether you could have been exposed to hepatitis C and order a
free online test or speak to your GP to arrange testing.
