Our journey to Hepatitis C micro-elimination

What is hepatitis C?

Hepatitis C is a blood borne virus which can cause acute and chronic hepatitis. This can range in severity - some people become mildly unwell, while others develop lifelong illnesses, including liver cirrhosis and cancer, which can lead to death.

It is estimated that globally, 58 million people have the chronic hepatitis C virus and there are around 1.5 million new infections each year. While there is currently no effective vaccine against the virus, antiviral medicines have a cure rate of over 95%.

Our micro-elimination goals

Recognising the impact that hepatitis C can have on people's lives if left untreated, NHS England has set a target to eliminate hepatitis C before 2025. As part of a partnership with Gilead Sciences, we have developed our own plans to meet this target and micro-eliminate hepatitis C in our 12 Blood Borne Viruses (BBV) commissioned services in England..

To measure our progress towards micro-elimination, a forum made up of Drug and Alcohol Providers, NHSE, Hepatitis C Trust and Gilead Sciences co-developed a definition and quality standards for micro-elimination. Micro-elimination is therefore defined as:

• 100% of clients in structured treatment are offered a hepatitis C test

• 100% of those with a history of injecting have been tested for hepatitis C

• 90% of current and previous injectors (at risk) have a hepatitis C test date within the last 12 months

• 90% of clients who’ve tested positive for hepatitis have commenced or completed treatment

Whilst the idea of micro-elimination is centred around injecting drug users, clients can be vulnerable to blood borne viruses (which includes hepatitis c) for a variety of reasons: through sex, tattoos, sharing razors, sharing drug using equipment and even sharing toothbrushes. It’s for this reason we encourage our BBV commissioned services to test every client whether or not they inject. This means no one will miss out on timely, appropriate treatment and ultimately the chance to get better.

Which of our English services are commissioned to deliver BBV services?

Our BBV commissioned services are doing vital work and are making progress towards achieving our goal of micro elimination. 

Some of our services have now achieved micro-elimination, and the others are very close.

• Bournemouth, Christchurch and Poole

• Cornwall

• Darlington - achieved micro-elimination in September 2023

• Lincolnshire

• Liverpool - achieved micro-elimination in January 2024

• North East Lincolnshire (Grimsby)

• North Lincolnshire (Scunthrope) - achieved micro-elimination in November 2023

• North Somerset

• Redcar and Cleveland

• Rotherham 

• Shropshire - achieved micro-elimination in December 2023

• Wigan and Leigh

Any service that declares will continue a comprehensive testing programme to sustain their micro-elimination status and strive towards our overall ambition of complete elimination of hepatitis C going forward.