Between July and September 2021, a total of 2,483 laboratory reports of hepatitis C were reported to UKHSA previously PHE). There was a 14% increase in the number of reports compared to the third quarter of 2020 (n=2,179). This increase is due to the addition of previously missing backdated confirmed hepatitis C laboratory reports originating from either the private laboratory Abbott (formerly known as Alere), or a laboratory from the North West region.    

Since 2017, one laboratory in the North West of England has undertaken hepatitis C 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 (95% complete). Where known males accounted for 67%  of reports which showed enhancement comparing with previous quarters and years (1). Adults aged 35 to 54 years accounted for 57% of the total number of hepatitis C reports.

Table 1. Laboratory reports of hepatitis C in England and Wales, July to September 2021

Age group	Male	Female	Unknown	Total
1 to 4 years	0	0	0	0
5 to 9 years	1	0	0	1
10 to 14 years	4	0	0	4
15 to 24 years	25	20	4	49
25 to 34 years	224	159	14	397
35 to 44 years	491	231	32	754
45 to 54 years	455	177	35	667
55 to 64 years	259	113	11	383
≥65 years	120	91	2	213
Unknown	0	1	14	15
Total	1,579	792	112	2,483

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 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 July and September 2021, 2,370 out of 2,383 individuals in England had been allocated to an ODN.

Table 2. Laboratory reports of hepatitis C by Operational Delivery Network, July to September 2021

Primary ODN	Total
Barts	74
Birmingham	134
Bristol and Severn	69
Cheshire and Merseyside	152
Eastern Hepatitis Network	91
Greater Manchester and Eastern Cheshire	146
Humberside and North Yorkshire	56
Kent Network via Kings	30
Lancashire and South Cumbria	113
Leicester	66
North Central London	233
North East and Cumbria	196
Nottingham	77
South Thames Hepatitis Network	262
South West Peninsula	44
South Yorkshire	64
Surrey Hepatitis Services	75
Sussex Hepatology Network	69
Thames Valley Hep C ODN	25
Wessex Hep C ODN	56
West London	155
West Yorkshire	75

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 more than one ODN.

Reference

1. UKHSA (2020). ‘Hepatitis C (England and Wales): 2020’,