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Increase in testing and treatment supports progress to elimination of hepatitis C in Wales

Published: 28 July 2023

On World Hepatitis Day, the latest annual report from Public Health Wales into blood borne viruses (BBVs), including hepatitis B, hepatitis C, and HIV infections, shows there has been progress towards eliminating these infections as a public health problem by 2030 in Wales.  

The number of newly-diagnosed people with chronic hepatitis C has reduced by a third since 2015, to just over 300 in 2022, while at the same time the numbers of people getting tested has exceeded pre-pandemic levels of 75,000 tests per year.   

While more than 3,000 people in Wales have initiated treatment for hepatitis C since 2015, Public Health Wales experts are encouraging more people to come forward for testing and treatment to ensure that the elimination goal of 2030 is achieved.  

In the UK, overall prevalence of chronic hepatitis C is low.  However, some groups are at greater risk of infection - including people who currently, or have previously injected drugs.     

Treatment for hepatitis C has improved in the past five years and is now far more effective than that prescribed previously.  This means that there may be people who have not been able to complete treatment in the past that can try again with the new medication and expect a much better outcome.   

Symptoms of the disease include feeling tired all the time, flu-like symptoms, nausea and loss of appetite, so are often mistaken for other illnesses. 

The report also looked at hepatitis B and HIV rates.  All babies in the UK born on or after 1 August 2017 are offered three doses of hepatitis B-containing vaccine as part of the NHS routine childhood immunisation programme. Wales has consistently achieved over 95% uptake of the 6-in-1 immunisations which includes hepatitis B.   

Diagnosis of new HIV infections in Wales is the lowest among UK nations, and has more than halved since 2017, with 60 new positive cases identified in 2021.  This has coincided with a seven-fold increase in people in at-risk groups being prescribed Pre-exposure Prophylaxis (PrEP) medicine to those at risk.  PrEP reduces the risk of contracting HIV through sex by 99% when taken as prescribed, and wider access to it has resulted in greatly reduced HIV transmission in the UK.  

Professor Daniel Thomas, Consultant Epidemiologist in the Communicable Disease Surveillance Centre at Public Health Wales, said:

“World Hepatitis Day is an opportunity for us to raise awareness of hepatitis C testing and the availability of effective and easy to use treatment. Public Health Wales supports the strategy by the World Health Organization, along with Welsh Government, to eliminate hepatitis B and C as a public health threat by 2030.   

“Because the virus remains in the body – often silently - for many decades, people who have been at risk in the past may be unaware that they are infected. 

“Public Health Wales has developed a free, completely confidential postal testing service for blood borne viruses like hepatitis C and sexually transmitted infections. 

“I would urge anyone who thinks they might be at risk - including those who have ever injected drugs - to access this service, look at the NHS 111 website or to consult your GP.  This will enable you to put your mind at rest, and if you are affected, to access and complete treatment.   

“In addition, and specifically in relation to hepatitis C, we are keen to encourage those people who have previously started hepatitis C treatment but were not able to complete it, or those who were not re-tested after treatment, to get tested and if necessary treated again.” 

Rachel Halford, CEO of the Hepatitis C Trust, said:

“Marking the 12th World Hepatitis Day is a wonderful opportunity to celebrate all that’s been achieved on the road to elimination in Wales but it’s also a reminder of how much further we need to go. 

“We are fast approaching the Welsh Government’s hepatitis C elimination target dates and there is no time to waste to reach the people who remain undiagnosed. 

“You can go many years before you experience any symptoms of hepatitis C but the damage the virus can do to your liver as it goes undetected can be life-threatening. People can be exposed to hepatitis C a number of ways, including having a blood transfusion before the early 1990s, having medical treatment or a tattoo abroad or via injecting drugs use. 

“If you’re worried about hepatitis C, get a free postal testing kit or ask your GP for a hepatitis C test today.”