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Hep C increases 'need primary care intervention'

Hospital admissions, liver transplants and deaths from hepatitis C (HCV) have all risen in the UK, leading experts to call for expansion of treatment into primary care and prisons. 

The latest figures released by Public Health England (PHE) show that deaths from HCV have more than quadrupled from 98 in 1996 to 428 in 2012. 

Liver transplant first registrations, where post-hepatitis C cirrhosis was an indication, have also quadrupled from 45 in 1996 to 188 in 2013. 

Around 214,000 individuals are chronically infected with HCV in the UK, the figures, which were released for World Hepatitis Day today show. 

Injecting drugs continues to be the most important risk factor for developing HCV. Around 50% of people who currently inject drugs are thought to be infected, according to the report. 

People who received blood transfusions in the UK before September 1991 are also at risk of being infected. 

Only 28,000 HCV patients in England were treated between 2006 and 2011, just 3% of those chronically infected. 

Statistical modelling suggests that nearly 10,850 individuals are currently living with HCV-related cirrhosis or liver cancer in England, and predicts that this figure will rise to 13,590 in 2025 if low coverage of current treatments is maintained.

If standard treatment was scaled up to complete coverage over the next 15 years, the model predicts that over 4,100 fewer people could be living with HCV-related liver cirrhosis and cancer by 2025. 

However, the same reduction could be achieved through using more effective treatments and doubling the number treated over the next 10 years. 

If rapid scale-up and more effective treatments were implemented, 8,340 fewer people could be living with the fall-out of the disease by 2025. 

Dr Helen Harris, a hepatitis C expert at PHE, who led the publication of the report, 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. 

“Such measures must go hand-in-hand with effective prevention activity, like drug treatment and safe injecting practices for people who inject drugs, if we are to tackle hepatitis C and the disease it causes.”

Charles Gore, chief executive of The Hepatitis C Trust said: “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. To achieve this we need a muti-sectoral, partnership approach. 

“The new screening initiative in prisons is a fine example of such an approach in practice and we are delighted to be working with PHE and NHS England to extend this into a properly comprehensive plan for scale-up across England. Deaths from hepatitis C are now eminently preventable. It is up to us to see that we do prevent them.”