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UK hep C hospital admissions, transplants, and deaths have all risen

Figures renew calls for concerted action to stave off personal toll and NHS costs

Caroline White

Monday, 28 July 2014

Illness and deaths from hepatitis C (HCV) have all risen across the UK, reveal new figures on hospital admissions and liver transplants for the infection, published today by Public Health England (PHE).

Hospital admissions for end stage liver disease associated with HCV infection have risen from 608 in 1998 to 2,390 in 2012, while deaths have risen from 98 in 1996 to 428 in 2012.

Liver transplant first registrations for HCV cirrhosis have quadrupled from 45 in 1996 to 188 in 2013.

These figures, which are released as part of the PHE annual report on hepatitis C in the UK, to coincide with World Hepatitis Day, have prompted renewed calls for concerted action to curb the toll of ill health and death and associated NHS costs.

Last week, a report published by the European Centre for Disease Prevention and Control showed that the numbers and notification rates of hepatitis C are nearly twice as high as those of hepatitis B.

Most recent national estimates suggest that around 214,000 people are chronically infected with HCV in the UK.

At risk are those who currently inject drugs or who have done so in the past, even if only once and those who received blood transfusions in the UK before September 1991. And anyone who has received medical or dental treatment in countries where HCV is common and infection control may be poor may also be infected.

Although antiviral treatments that will successfully clear HCV in most patients are available and approved for use in the UK, only an estimated 28,000 patients in England were treated between 2006 and 2011 – just 3% of those chronically infected each year.

Calculations suggest that nearly 10,850 people are currently living with HCV-related cirrhosis or liver cancer in England, with this figure expected rise to 13,590 in 2025 if low coverage of current treatments is maintained.

But if rapid scale-up to complete coverage and more effective treatments were implemented, 8,340 fewer people could be in this situation by 2025.

Dr Helen Harris, an HCV expert at PHE, and lead author of the report, said it highlighted national progress in tackling the infection, but also showed the scale of the challenge ahead.

“Transmission amongst risk groups continues and significant numbers remain undiagnosed and untreated. With many new and improved treatments on the horizon, it is increasingly important to raise awareness of the infection so that more individuals can be diagnosed and treated,” she said.

“As well as encouraging more testing and treatment, there is an urgent need for better monitoring and reporting of treatment outcomes, as well as expansion of treatment into non-traditional settings, such as primary care, drug treatment centres, and prisons,” she suggested.

Charles Gore, chief executive of the Hepatitis C Trust, added: “Despite the examples of good practice and the availability of effective treatments, we must accept that the rising hospital episodes and deaths, the poor diagnosis rate and the shockingly low level of treatment means we are failing patients.”

And he insisted: “What this report highlights is the pressing need for immediate scale-up of the whole response to hepatitis C from prevention, through diagnosis and into treatment.” This would require a multi-sectoral, partnership approach, he said.

“Deaths from hepatitis C are now eminently preventable. It is up to us to see that we do prevent them,” he said.

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