Theme: Epidemiology & Public Health Research Year: 2019
Background: People who inject drugs (PWID) are the largest risk group for Hepatitis C (HCV) in the
UK. Early diagnosis, referral to and completion of antiviral treatment are important to reduce
morbidity and transmission.
Methods: Data and virological results from the 2017 unlinked-anonymous bio-behavioural survey of
PWID in England, Wales and Northern Ireland were analysed. Factors associated with uptake or
missed opportunities for HCV testing and access to care were examined for those currently infected
Results: Of 1,735 participants who had injected during the preceding year, 56% were HCV antibody
positive and of these, half (51%) had a current infection (HCV RNA positive). Among these, 91%
(427/468) reported ever being tested, of whom 55% (201/366) were aware of their current
infection. Most of those diagnosed (77%;141/182) reported seeing a hepatitis clinician; however
only 26% (37/141) of these reported HCV treatment uptake. Denominators exclude non-responses
to survey questions.
Among PWID unaware of their current HCV infection, 41% (67/165) reported a recent HCV test (≤2
years ago), 58% >2 years ago (95/165) and 2% (3/165) reported never testing. Most of those not
tested recently reported attendance at a GP (74%) or needle and syringe programme (88%) within
the last year, and 80% reported currently being prescribed a substitution drug.
Conclusion: Although lifelong HCV testing among those currently infected with HCV was high, threefifths had not tested recently. Half of those with current HCV infection remained undiagnosed.
Health service utilization was high, suggesting missed/further opportunities for testing. Most of
those aware of their current infection had accessed specialist HCV healthcare, however only one
quarter engaged in treatment. Targeted interventions to improve frequency and uptake of HCV
testing and strengthen the care pathway are essential to reach the WHO target of elimination by
Disclosure of Interest Statement: No disclosures of interest