Between October and December 2021, a total of 2,612 laboratory reports of hepatitis C were reported to UKHSA (previously PHE). There was a 8% decrease in the number of reports compared to the fourth quarter of 2020 (n=2,841). This decrease is very likely due to the overall impact of the COVID-19 pandemic on health services, including diagnostic testing for hepatitis C virus (HCV).    

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 (98% complete). Where known males accounted for 95%  of reports which is consistent with previous quarters and years (1). Adults aged 35 to 54 years accounted for 58% of the total number of hepatitis C reports.

Table 1. Laboratory reports of hepatitis C in England and Wales, October and December 2021

Age group	Male	Female	Unknown	Total
1 to 4 years	0	1	0	1
5 to 9 years	1	0	0	1
10 to 14 years	1	0	0	1
15 to 24 years	36	16	4	56
25 to 34 years	228	114	20	362
35 to 44 years	547	219	45	811
45 to 54 years	492	173	32	697
55 to 64 years	290	118	16	424
≥65 years	125	78	2	205
Unknown	41	0	13	54
Total	1,761	719	132	2,612

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 2021, 1,713 out of 2,549 individuals in England had been allocated to an ODN.

Table 2. Laboratory reports of hepatitis C by Operational Delivery Network, October and December 2021

Primary ODN	Total
Barts	70
Birmingham	138
Bristol and Severn	64
Cheshire and Merseyside	155
Eastern Hepatitis Network	84
Greater Manchester and Eastern Cheshire	146
Humberside and North Yorkshire	36
Kent Network via Kings	17
Lancashire and South Cumbria	91
Leicester	30
North Central London	66
North East and Cumbria	147
Nottingham	70
South Thames Hepatitis Network	136
South West Peninsula	37
South Yorkshire	51
Surrey Hepatitis Services	63
Sussex Hepatology Network	55
Thames Valley Hep C ODN	22
Wessex Hep C ODN	45
West London	121
West Yorkshire	69

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 in England and Wales 2020’.