ENGLAND continues to make measurable progress towards hepatitis C elimination. This is based on a government report tracking alignment with the World Health Organisation (WHO) targets up to the end of 2024.
Hepatitis C, a bloodborne virus that infects the liver and can lead to cirrhosis, liver failure and hepatocellular carcinoma if untreated, remains a significant global public health concern, with around 50 million people affected worldwide.
The latest data show sustained reductions in chronic infection and improvements in treatment coverage, though gaps in diagnosis and prevention persist among high-risk groups.
Falling Prevalence Signals Impact of Treatment
Chronic hepatitis C prevalence in England continues to decline, with an estimated 50,200 adults living with the infection in 2024. This represents a fall of 61.1% since 2015, driven largely by expanded testing and the widespread use of direct-acting antiviral therapy. These treatment courses, typically lasting 8 to 12 weeks, have enabled many people to be cured.
Prevalence has also dropped among intravenous drug users, the group at highest risk of infection, falling to 5.2% in 2024. In parallel, 46.8% of people who inject drugs have now cleared the virus, more than double the proportion recorded in 2015.
Diagnosis Gap and Uneven Engagement Remain Barriers
An estimated 84.6% of people living with hepatitis C have been diagnosed, falling short of the 90% WHO target.
Around 9,800 people without a history of intravenous drug use are also estimated to be living with chronic infection, although data in this group remains limited.
Laboratory reports show that where sex is recorded, more than two-thirds of new diagnoses are in men. Late diagnosis remains a concern, with some individuals presenting with advanced fibrosis or cirrhosis within three years of diagnosis.
Harm Reduction and Hepatology
Progress is closely tied to harm reduction services, yet gaps persist. Around one third of people who inject drugs report inadequate access to sterile needles and syringes, and distribution levels remain below WHO targets.
Reinfection rates remain notable, particularly among those recently treated or with a history of imprisonment, highlighting ongoing exposure risks. Sustained harm reduction is required to reduce reinfection risk
Testing Reach Improves but Diagnosis Gaps Remain
Targeted testing initiatives, including emergency department opt-out programmes, have identified individuals not engaged in routine services. However, highest diagnostic yield continues to be seen in drug services, prisons and community outreach settings.
UK Health Security Agency data also highlight stigma as a persistent barrier affecting testing, treatment uptake and wellbeing, reinforcing the need for more person-centred, peer-supported approaches.
Hepatitis C-related mortality in England remains low, at between 0.40 and 0.86 deaths per 100,000 population in 2024, below the WHO threshold of 2 per 100,000. While this indicates strong progress, sustained efforts in prevention, diagnosis and equitable access to care remain essential to consolidate gains towards elimination.
Reference
GOV.UK. Hepatitis C in England 2025. 2026. Available at https://www.gov.uk/government/publications/hepatitis-c-in-the-uk/hepatitis-c-in-england-2025. Last accessed 15 April 2026.
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