Eliminating hepatitis C: time to embrace primary care’s critical role?

• Published in: British journal of general practice Vol. 71; no. 707; pp. 250 - 251
• Main Authors: Jarvis, Helen, Whiteley, David
• Format: Journal Article
• Language: English
• Published: London Royal College of General Practitioners 01.06.2021
• Subjects: Antiviral drugs; Gays & lesbians; Hepatitis; Hepatitis C; HIV; Human immunodeficiency virus; Liver cancer; Liver cirrhosis; Liver diseases; Mens health; United Kingdom > UK
• ISSN: 0960-1643; 1478-5242
• DOI: 10.3399/bjgp21X715901

The hepatitis C virus (HCV) is a blood-borne flavivirus causing liver infection in humans, which exhibits 55% to 85% chronicity after initial acute infection. Left untreated a significant percentage of those with chronic HCV will go on to develop liver cirrhosis and hepatocellular carcinoma (HCC). In the UK, HCV disproportionately affects marginalized populations, with past or present injecting drug use being the most important risk factor. Around half of people who inject, or have injected drugs (PWID) across the UK are estimated to be HCV antibody positive, with around a quarter having active infection. Sexual transmission of HCV is rare among heterosexual partners, but presents a growing concern in communities of HIV-positive men who have sex with men (MSM), and HIV-negative MSM using pre-exposure prophylaxis (PrEP) for HIV. Other underserved populations at increased risk of HCV include those in prison, the homeless, and communities who have close links to countries where HCV is endemic. HCV is now a largely curable disease. The advent of direct acting antiviral (DAA) therapy in 2011 has progressively transformed the treatment of HCV beyond recognition.