Laboratory reports of hepatitis C in England and Wales: October to December 2020
Updated 2 August 2022
Applies to England and Wales
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Between October and December 2020, a total of 2,841 laboratory reports of hepatitis C were reported to Public Health England (PHE) – now the UK Health Security Agency (UKHSA).
There was a 15.0% decrease in the number of reports compared to the fourth quarter of 2019 (n=3,341), see Table 1. This decrease is very likely due to the overall impact of the coronavirus (COVID-19) pandemic on health services, including diagnostic testing for the hepatitis C virus (HCV).
Declines in testing and diagnoses reflect the impact of pandemic-related public health measures introduced in March 2020. Reasons for this decline are multifactorial: including but not restricted to deployment of staff, disruption to and/or reconfiguration of health services reducing access to testing, disruption to laboratory consumables due to increases in demand during the pandemic and impact of social and physical distancing measures resulting in fewer opportunities for onward transmission.
Since 2017, one laboratory in north-west England has undertaken HCV dried blood spot testing alongside hepatitis C routine laboratory testing. This single laboratory has taken on testing for a large part of the country – however, some samples where geographical information is lacking may have been incorrectly assigned to this specific laboratory rather than the laboratory from which the sample originated.
Age and sex were well reported (>92.6% complete). Where sex was known, males accounted for 69.7% (1,835 of 2,632) of reports which is consistent with previous quarters and years.
Adults aged 25 to 44 years accounted for 51.6% of the total number of hepatitis C reports.
Table 1. Laboratory reports of hepatitis C in England and Wales, October to December 2020
| Age group | Male | Female | Unknown | Total |
|---|---|---|---|---|
| 1 to 4 years | 1 | 1 | 0 | 2 |
| 5 to 9 years | 0 | 0 | 1 | 1 |
| 10 to 14 years | 1 | 0 | 0 | 1 |
| 15 to 24 years | 36 | 21 | 3 | 60 |
| 25 to 34 years | 284 | 170 | 45 | 499 |
| 35 to 44 years | 635 | 243 | 77 | 955 |
| 45 to 54 years | 501 | 178 | 49 | 728 |
| 55 to 64 years | 254 | 107 | 25 | 386 |
| ≥65 years | 112 | 71 | 4 | 187 |
| Unknown | 11 | 6 | 5 | 22 |
| Total | 1,835 | 797 | 209 | 2,841 |
Individuals aged under 1 year are excluded, since positive tests in this age group may reflect the presence of passively-acquired maternal antibody rather than true infection.
Laboratory reports are not reliable for differentiating acute and chronic hepatitis C infections. Laboratory reports include individuals with a positive test for hepatitis C antibody, antigen and/or detection of hepatitis C RNA.
A small proportion of these specimens are diagnosed following dried blood spot (DBS) testing, however not all DBS testing is reported by laboratories.
In Table 2, laboratory reports are presented broken down by Operational Delivery Network (ODN). ODNs were launched in July 2013 following the publication of the NHS England strategy to sustain and develop clinical networks.
ODNs are the networks through which hepatitis C treatment is being delivered across England. Between October and December 2020, 2,594 out of 2,777 individuals in England have been allocated to an ODN.
Table 2. Laboratory reports of hepatitis C by Operational Delivery Network, October to December 2020
| Primary ODN | Total |
|---|---|
| Barts | 119 |
| Birmingham | 234 |
| Bristol and Severn | 114 |
| Cheshire and Merseyside | 101 |
| Eastern Hepatitis Network | 147 |
| Greater Manchester and Eastern Cheshire | 163 |
| Humberside and North Yorkshire | 90 |
| Kent Network via Kings | 53 |
| Lancashire and South Cumbria | 55 |
| Leicester | 79 |
| North Central London | 292 |
| North East and Cumbria | 190 |
| Nottingham | 65 |
| South Thames Hepatitis Network | 163 |
| South West Peninsula | 62 |
| South Yorkshire | 91 |
| Surrey Hepatitis Services | 84 |
| Sussex Hepatology Network | 139 |
| Thames Valley Hep C ODN | 28 |
| Wessex Hep C ODN | 100 |
| West London | 137 |
| West Yorkshire | 88 |
ODNs are based on NHS England Clinical Commissioning Groups (CCGs) geographic boundaries. NHS England allocates a primary or lead ODN for CCGs which may cross 2 ODNs.