Research and analysis

Laboratory reports of hepatitis C in England and Wales: July to September 2020

Updated 2 August 2022

Applies to England and Wales

Between July and September 2020, a total of 2,179 laboratory reports of hepatitis C were reported to Public Health England (PHE) – now the UK Health Security Agency (UKHSA).

There was a 41.6% decrease in the number of reports compared to the third quarter of 2019 (n=3729), see Table 1. This decrease is very likely due to the overall impact of the COVID-19 pandemic on health services, including diagnostic testing for the hepatitis C virus (HCV).

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 be 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 69.6% (1,442/2,072) of reports which is consistent with previous quarters and years.

Adults aged 25 to 44 years accounted for 54.4% of the total number of hepatitis C reports.

Table 1: Laboratory reports of hepatitis C in England and Wales, July to September 2020

Age group Male Female Unknown Total
1 to 4 years 2 2 0 4
5 to 9 years 0 0 0 0
10 to 14 years 0 0 0 0
15 to 24 years 35 18 2 55
25 to 34 years 254 136 14 404
35 to 44 years 518 212 40 769
45 to 54 years 363 129 36 525
55 to 64 years 182 74 8 263
≥65 years 79 50 4 133
Unknown 9 9 3 21
Total 1442 630 107 2,179

Individuals aged under one 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.

Table 2: Laboratory reports of hepatitis C by Operational Delivery Network, July to September 2020

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 2020, 2,104 out of 2,147 individuals in England have been allocated to an ODN.

Primary ODN Total
Barts 80
Birmingham 209
Bristol and Severn 113
Cheshire and Merseyside 84
Eastern Hepatitis Network 123
Greater Manchester and Eastern Cheshire 148
Humberside and North Yorkshire 84
Kent Network via Kings 31
Lancashire and South Cumbria 42
Leicester 61
North Central London 212
North East and Cumbria 174
Nottingham 63
South Thames Hepatitis Network 129
South West Peninsula 34
South Yorkshire 63
Surrey Hepatitis Services 45
Sussex Hepatology Network 98
Thames Valley Hep C ODN 28
Wessex Hep C ODN 100
West London 108
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 2 ODNs.

Lancashire and South Cumbria, South West Peninsula and Thames Valley Hepatitis C Network were ODNs which between them had 26 individuals that could also be assigned to a second ODN.