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HEPATITIS C

HEPATITIS C ELIMINATION : THE TIME IS NOW

Between 2015 and 2020 , The UK Health Security Agency ( UKHSA ) reported an estimated 37 per cent reduction in hepatitis C infections . 1 Now the whole system is readying itself for a final push to eliminate the disease

Hepatitis C is in decline in England . In its latest progress report UKHSA revealed that domestic cases of people living with chronic hepatitis C virus ( HCV ) infection fell to 81,000 in 2020 . 1 The reduction in cases has been driven largely by improved access to treatment in recent years , 1 and through an innovative partnership which has seen NHS England , the pharmaceutical sector and health services working together to identify programmes and practices which will help reach the national goal of HCV elimination .

UKHSA also reported ‘ incredible progress ’ in HCV-related mortality , which fell by 35 per cent between 2015 and 2020 ; 1 exceeding the
World Health Organization ’ s ( WHO ) target of 10 per cent . 1 In fact , with HCV-related annual mortality now lower than two per 100,000 , England has already met the WHO ’ s interim target for 2030 well ahead of schedule . 1
These figures are of course to be welcomed – but a bigger goal remains on the horizon . In 2016 , WHO set out its roadmap to eliminating HCV as a public health threat by 2030 – meaning a reduction in new chronic infections of 90 per cent and a 65 per cent decrease in mortality compared with 2015 levels . 2
The time is now . Across the health system , people are coming together to unite around one vision : achieving elimination of HCV . Professor Graham Foster , clinical leader of NHS England ’ s hepatitis C programme , told The Sunday Times in February that by 2025 it is a ‘ realistic aspiration ’ for England to become the first nation to eliminate hepatitis C . 3
FROM TREATMENT TO ELIMINATION HCV is a blood-borne virus which most commonly affects the liver . 4 People often don ’ t experience symptoms of HCV until several years after infection , and if left untreated , it can cause scarring to the liver , cancer , and even death . 5
Fortunately , modern treatments have transformed the medical options available to patients , making HCV a curable disease for the majority of patients and meaning that most people who contract the virus and receive treatment will have a normal life expectancy . 6
And treatment is having a positive impact on individuals beyond physical health . A 2019 study led by Gilead in partnership with the clinical community found that HCV treatment had a positive impact on their engagement in society , emotional wellbeing and other aspects of their mental and physical health . 7
THE ROLE OF DRUG TREATMENT SERVICES A critical part of that journey is drug treatment services ( DTS ). HCV is a condition that disproportionately affects people from marginalised and underserved parts of society . Injecting drug use remains the main driver of HCV transmission in England and needle sharing remains a problem , posing a challenge in preventing transmission . 1
Gilead Sciences has supported the formation of a provider forum which brings together the national leads of the six largest DTS providers in England including the NHS Addictions Provider Alliance ( NHSAPA ) covering more than 150 services across England , with the shared goal of eliminating HCV in partnered drug treatment services by the end of 2023 – two years ahead of the national target .
Dr Prun Bijral , medical director
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