The UK Health Security Agency (UKHSA) has recently launched a genomic surveillance programme to monitor the hepatitis C virus (HCV) and its response to treatment
This program hopes to track the development of drug resistance, manage more difficulty in treating viral strains and detect outbreaks sooner.
Preventing hepatitis C virus (HCV) transmission
It is part of a wider plan to prevent the transmission of HCV and improve the effectiveness of national treatment programs.
By using advanced technology, the programme aims to provide a clearer picture of how HCV behaves in different populations, helping to stop ongoing transmissions and tailor treatment options.
The most recent data from UKHSA shows a large progress in reducing chronic hepatitis C infections across England.
A step forward in HCV diagnosis and treatment
The number of individuals aged 16 and older living with chronic HCV has dropped dramatically by 56.7% since 2015, from an estimated 129,400 to 55,900 in 2023.
This decline is largely due to NHS England’s HCV Elimination Programme, which has increased testing availability and expanded access to Direct Acting Antivirals (DAAs). These antiviral drugs, which have proven to be highly effective, have contributed significantly to improving treatment outcomes. As a result, the mortality rate related to hepatitis C has reached its lowest point in nearly a decade, with fatalities dropping from 0.69 per 100,000 people in 2015 to 0.41 per 100,000 in 2023.
Despite this success, there are still challenges to overcome; antiviral resistance is emerging, with data from 2023 showing that 5% of subtype 1a samples from untreated patients were resistant to one class of antiviral drugs.
Certain HCV subtypes in Asia and sub-Saharan Africa also show inherent resistance to some DAAs. To keep track of these changes, the UKHSA’s genomic surveillance programme will look for genetic markers of drug resistance, enabling a more proactive approach to the evolving virus and treatment strategies.
Early diagnosis of HCV
It is important to continue to have an early diagnosis of HCV. The virus can remain asymptomatic for years, allowing it to cause significant liver damage before it is detected.
Early detection enables people to access effective treatments that can prevent serious health issues such as liver disease and cancer. The virus is most commonly transmitted through blood-to-blood contact, often associated with sharing needles or other non-sterile injecting equipment.
People at a higher risk of contracting hepatitis C include individuals who have ever injected drugs, even if only once in the past, as well as those who have had medical procedures abroad, received blood transfusions before widespread screening, or have had unprotected sex with someone infected with the virus.
In response to these risks, NHS England launched a home testing service in May 2023, which has already had over 60,000 people order tests. This service provides easy access to testing for everyone over 18 in England.
Testing is quick, free, and can be done through a GP or online, making it more accessible to at-risk people. The availability of such services plays a key role in identifying individuals living with the virus without knowing it, ensuring they can receive the necessary treatment to prevent further complications.
These efforts to eliminate hepatitis C in the UK are one of the country’s most important public health goals.
The NHS has made significant progress, providing over 100,000 treatments since 2015, focusing on those most at risk, such as people in deprived communities.
Continued testing and early diagnosis are vital to eliminate the virus. The final phase of this effort will require collaboration between the government, healthcare providers, and the charity sector to identify and treat the remaining individuals living with the virus.
