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Hepatitis C

Direct-acting antivirals successfully treating hepatitis C, says Public Health England

A new report suggests early detection of the disease is key as treatment with direct-acting antiviral therapy in the initial stages has the best results.

Public Health England (PHE) is urging the public to get tested for hepatitis C after its latest figures revealed a fall in deaths from the disease, which it attributed to the introduction of direct-acting antiviral (DAA) therapy.

PHE’s annual report, published on 28 July 2017, estimated that around 200,000 people in the UK are unknowingly living with chronic hepatitis C, but it said that “revolutionary treatments” can successfully treat the disease in the vast majority of cases, with the best results in the earlier stages of the disease.

According to the report, Hepatitis C in the UK, people infected with the disease need to be found and treated as quickly as possible to sustain the recent nationwide drop in deaths from the condition.

The majority of cases in the UK are considered to be from marginalised and under-served groups in society, such as people who inject drugs.

Current data from PHE shows an estimated 10% reduction in mortality from hepatitis C-related end-stage liver disease and cancer in 2016, and the introduction of DAA drugs has resulted in a 50% reduction in need for liver transplantation for chronic hepatitis C infection.

Commenting on the report, Duncan Selbie, chief executive of PHE, said: “The recent fall in UK deaths looks likely to be the result of increased treatment with new direct-acting antiviral drugs, with an increase of nearly 50% over the past year, and of nearly 90% when compared with earlier years.

Sustaining increase in treatment

“Our ability to sustain this increase in treatment will ultimately be limited by our capacity to find and treat those who remain undiagnosed, and to help those who are diagnosed but untreated to engage with accessible treatment services.”

Helen Harris, clinical scientist at PHE’s Immunisation, Hepatitis and Blood Safety Department, said: “We strongly encourage anyone who may have been at risk of hepatitis C infection to get tested, whether or not they have any symptoms.

“We are hopeful that the increased access to improved treatments over recent years has contributed to the latest fall in deaths from severe hepatitis C-related liver disease. This, combined with interventions to prevent infection in the first place, can help us to achieve our vision of eliminating hepatitis C as a major public health threat in the UK.”

In June the Hepatitis C Trust criticised the results of a study carried out by the Cochrane Hepato-Biliary Group that cast doubt on the effectiveness of DAA drugs against hepatitis C.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2017.20203312

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