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HCV rate expected to rise in England without new therapies, larger uptake

The rate of adults with hepatitis C virus in England is predicted to increase through 2035 unless more treatment options become available and treatment uptake is increased, according to data from a recent study.

Researchers used three national database sources (ex-factory sales to National Health Service hospitals, Pharmex and IMS Health Hospital Pharmacy Audit Index) to gather sales data for pegylated interferon between 2006 and 2011 to determine how many people infected with hepatitis C virus (HCV) were receiving treatment. Investigators also measured current age and disease-stage to determine any probabilities for progression within a health-state model, and then used the model to predict the future disease burden and associated therapy.

Based on analyses, approximately 5,000 patients received treatment in 2011 and 28,000 from 2006 to 2011. Researchers predicted that without treatment, the number of decompensated cirrhosis and hepatocellular carcinoma patients will increase to 2,290 cases annually until 2035. Using current treatment levels, however, those cases could decline by 600 per year before peaking around 2030. Researchers also estimated that the number of treatment options and amount of treatment uptake must increase if it is to stop the rise in incidence and hold it at about 500 cases in 2030.

“If the future burden of HCV-related disease is to be averted, significant increases in treatment need to be achieved, and the National Institute for Clinical Excellence has recently issued guidance to ensure that more people at increased risk of hepatitis C (and B) infection are offered testing and treatment services,” the researchers wrote. “While reorganization of the National Health Service in England poses a challenge to hepatitis C provision … it also provides opportunities for better coordination of services; the development of integrated services that reach into communities — whether based in primary care, drug services, prisons or elsewhere — will be key for increasing access to HCV treatment.”