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NHS to Deliver Home-Based Hep C Tests

Tens of thousands of people at increased risk of hepatitis C will be able to confidentially order self-testing kits to their home from today, NHS England announced.

The NHS is planning to lead the world in the eradication of hepatitis C. NHS England's Hepatitis C Elimination Programme has already reduced deaths from the disease by 35% – and has exceeded the World Health Organisation’s (WHO) target of 10% more than threefold.

As the NHS steps up its bid to eliminate the disease, "this latest tool is placing England in pole position" to be among the first countries in the world to eliminate the virus as a public health concern, an NHS England spokesperson commented, ahead of the 2030 WHO commitment. In fact, the NHS is on track to eliminate Hep C by 2025, 5 years ahead of global targets.

Chronic Hep C Infection Cases in the UK Have 'Fallen Dramatically'

The Health and Safety Executive (HSE) estimated that 0.5% to 1.0% of the UK population had a chronic hepatitis C virus (HCV) infection.

The UK Health Security Agency (UKHSA) highlighted that the number of people living with Hep C infection in England had "fallen dramatically" by 37% in the general population since 2015 to 2020. The prevalence of chronic HCV infection in England is estimated to be 81,000 in 2020 (95% CrI: 66,000 to 94,000)

The agency explained that the "substantial" fall in numbers of people with chronic infection was largely due to improved access to direct-acting antivirals, with around 58,850 treatments having taken place between tax years 2015 to 2016 and 2020 to 2021. 

"We should also be encouraged by the incredible progress that has been made in reducing HCV-related mortality," said the UKHSA. It added that England had already met the WHO 2030 interim target of achieving an HCV-related annual mortality rate below 2 per 100,000.

The UKHSA commented that increases in those ever infected with HCV, combined with recent decreases in chronic HCV infection amongst people who inject drugs between 2015 and 2020, suggested that increased access to treatment, rather than improved prevention of infection due to improved harm reduction, was the main driver of the reduction in prevalence of chronic HCV infection among people who inject drugs. 

Discreet and Confidential

The "discreet", at-home Hep C testing kits would be free to order online, and involve a finger prick, with the blood sample posted to a laboratory for analysis. Those who received a positive test result would be contacted and referred for treatment. NHS England emphasised that Hep C is now "mostly curable" on the NHS. 

"The new self-testing kits aim to reach people who may not be engaged with other services such as drug and alcohol support, prison and probation services, as well as people who may have potentially been exposed to virus in the past, or who do not feel able to approach their GP," explained the NHS England spokesperson.

Commenting for Medscape News UK, Vanessa Hebditch, director of policy at the British Liver Trust, said that the charity was "delighted" at the news of the NHS Hepatitis C web portal being launched.

"One of the key challenges in addressing Hepatitis C is the fear of stigma that prevents many individuals at risk from coming forward. This web portal provides a safe and accessible platform for people to seek information, get tested, and access support without fear of judgment or discrimination," she said.

Professor Sir Stephen Powis, NHS national medical director counselled that the latest tool would be "critical" to ensuring more people can receive the treatment they need, or peace of mind, at the earliest opportunity.

Being born, or having lived, in a country where the Hep C is endemic – such Pakistan, India, and Bangladesh – increased a person's risk of having the disease, so the web portal "will be available in both Urdu and English", NHS England said.

"We are on track to eliminate hepatitis C as a public health threat by 2030, which may rank among the most significant NHS successes in history," Prof Powis commented.

He pointed out that, as patient numbers got smaller, and each remaining case became "harder to find and cure", it was vital to offer easy-to-access self-test kits – "especially for those who have been exposed to the virus but may be reluctant to come forward". 

The effort is thanks, in part, to an innovative deal with pharma companies that means they help find patients with the condition. The new test service was developed in partnership with Preventx and Nuom, with further input from the Hepatitis C Trust.