‘Radical change’ needed to hit hepatitis C targets

A “radical change” in the health service’s response to the hepatitis C virus among people who inject drugs is required if NHS England’s target to eliminate the disease by 2025 — five years ahead of the global deadline set by the World Health Organization (WHO) – is to be met.

The Public Health England (PHE) 2018 annual report into hepatitis C, published on 4 May 2018, makes no mention of NHS England’s ambition, which was announced in January 2018, but it says the WHO milestone to reduce hepatitis C virus related morbidity and mortality by 2030 “should be within reach” if improvements in the number of people accessing treatment is sustained.

It will only be achieved, however, if health services have the capacity to find and treat people who are currently undiagnosed, and it warns that a change in policy on hepatitis C among drug injectors is needed.

The report highlighted that just 45% of people who inject drugs said that existing needle exchange services met their needs.

And while cases of needle and syringe sharing have declined from 28% in 2005 to 18% in 2016, the rate of infection has remained the same or risen slightly among people who inject drugs. There was a “small, but significant” 3% increase in infections in new injecting drug users between 2011/2012 and 2015/2016, according to the report.

The report added: “There is currently little evidence to support a fall in the number of new hepatitis C virus infections; if the goals to reduce these levels are to be reached, then a radical change in our response to hepatitis C virus among people who inject drugs is required.”

The annual report comes just a month after a report by the All Party Parliamentary Group on Liver Health warned that NHS England had no hope of meeting its 2025 elimination target unless the government developed a national strategy to wipe out the curable and preventable virus

Aidan Ryatt, policy and parliamentary adviser at the Hepatitis C Trust, said: “What really needs to happen is for the government to publish its own elimination strategy to set out the detail about how this 2025 target is achievable.

“It would be interesting to find out why the NHS England target is not mentioned in the PHE annual report; it could be that the target was only announced in January, but I don’t see any reason why it’s not been mentioned.”