In July 2012 the Health Protection Agency (HPA) released its most recent report on incidence of hepatitis C in the UK.
- An estimated 216,000 individuals are chronically infected with hepatitis C (HCV) in the UK; most of this infection (~90%) is genotype 1 and genotype 3.
- Injecting drug use continues to be the most important risk factor. Data from the Unlinked Anonymous Monitoring (UAM) survey of injecting drug users (IDU) suggest that levels of infection in this group remain high in 2011 (45% in England, 29% in Northern Ireland and 39% in Wales); levels of infection among IDU surveyed in Scotland in 2010 are higher still (55%).
- Both hospital admissions and deaths from HCV-related end stage liver disease (ESLD) and hepatocellular carcinoma (HCC) are continuing to rise. Hospital admissions have risen from 612 in 1998 to 1,979 in 2010, while deaths have risen from 98 in 1996 to 323 in 2010. An overall increase in registrations for liver transplants with a code of post-hepatitis C cirrhosis has been observed from 45 in 1996 to 101 in 2011.
- In England, statistical modelling predicts that 15,840 individuals will be living with HCV-related cirrhosis or HCC in England in 2020 if left untreated.
- Action plans and work programmes are in place across the UK to help tackle the infection, and public health action is focused in four main areas prevention of new infections, increasing awareness of infection, increasing testing and diagnosis and getting diagnosed individuals into treatment and care.
- In England, enhanced surveillance of newly acquired HCV infection in men who have sex with men (MSM) provides evidence of ongoing, but declining sexual transmission of HCV among HIV positive MSM. In this population, the estimated incidence of infection declined significantly over time from 7.38 per 1,000 person years in 2008 to 1.46 in 2011(p<0.001).
Although this report continues to include very little information about HIV/HCV coinfection except for the reported reduction in sexual transmission of HCV in HIV positive gay men. This should be welcomed cautiously, as annecdotally diagnosis is still common in London clinics.
Ref: Hepatitis C in the UK. HPA 2012.