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84.6% diagnosed, 90% needed: the gap standing between England and a first

Qurexa Editorial Team22 October 20267 min read 0 0
84.6% diagnosed, 90% needed: the gap standing between England and a first

What happened

The UK Health Security Agency has published its regional hepatitis C reports for 2025, with the pages for seven English regions updated on 21 October 2026. Hepatitis C is a virus that infects the liver. Many people carry it for years without feeling ill, which is the heart of the problem. Left untreated it can scar the liver badly. Treated, it is now curable in most people with tablets taken for eight to twelve weeks. England is trying to become one of the first countries in the world to eliminate it as a public health problem. The World Health Organization sets the bar, and England has now cleared one of the two main hurdles: treatment coverage of 80% or more. To have elimination confirmed, that has to be held for at least two years in a row. The hurdle still standing is diagnosis. Provisional estimates put the share of people living with hepatitis C in England who have actually been diagnosed at 84.6%. The target is 90%. The regional reports show how uneven the picture is underneath that national figure.

Why this matters

Being close is not the same as arriving. Those 5.4 percentage points represent thousands of people walking around with a curable infection and no idea they have it. That matters for them, because untreated hepatitis C damages the liver slowly and quietly. It also matters for everyone else, because a person who does not know they are infected can pass it on. There is a bigger point too. Very few countries get to say they have eliminated a serious infectious disease. England is genuinely in reach of it, and the remaining obstacle is not a missing medicine or a funding gap in research. It is finding people and testing them. That is an unusually solvable problem. The direction of travel is encouraging. Estimated chronic cases in England fell to around 50,200 in 2024, down 61.1% from 129,000 in 2015. A drop of that size in under a decade is a real public health achievement, built on treatments that only became widely available in the mid-2010s. But the last stretch is always the hardest, because the people still undiagnosed are by definition the ones hardest to reach.

What the evidence actually says

The regional reports make the averages look misleading. In London, treatment coverage was 75.1% — below the WHO target of 80%. There were 4,552 new laboratory reports of hepatitis C among London residents in 2024, a rate of 50.1 per 100,000 people, and reports were up 11.2% on 2023. In Yorkshire and the Humber, treatment coverage was 85.2%, comfortably above the target. There were 1,514 new laboratory reports in 2024, a rate of 26.7 per 100,000, with reports up 21.8% on 2023. Those rising report numbers need careful reading, and the reports themselves say so. More positive tests can mean more infection. It can also mean more testing. The South West report notes its highest annual rate in ten years, but links the trend partly to better detection, including the expansion in 2024 of opt-out testing in emergency departments — where patients having blood taken are offered a hepatitis test unless they decline. So a rise in reports may be the system working rather than failing. That is an important distinction, and it is a good sign that UKHSA states it plainly rather than letting the headline number speak for itself. One more honest caveat: the 84.6% diagnosis figure is described as provisional, and estimating how many people have an infection nobody has found is inherently difficult.

Qurexa perspective

Hepatitis C treatment is a course of tablets, usually for eight to twelve weeks, and finishing the course is what produces the cure. That is where community pharmacy and delivery genuinely matter. The people least likely to be diagnosed are often the people whose lives make a three-month course of daily tablets hard to complete: unstable housing, shift work, no car, a long way from the clinic. A missed collection becomes a missed week, and a missed week puts the cure at risk. Our prescription delivery service across Lincolnshire exists for exactly this sort of gap — not because collecting a prescription is difficult for most people, but because for some people it is the thing that quietly derails treatment. Medication adherence support is part of the same picture: a reminder, a routine, a known face. We would not claim this is the main answer to hepatitis C in England. Testing is. But if you or someone you know is starting treatment and worried about keeping up with it, it is worth asking your pharmacy what help is available locally. Most will have something, and asking costs nothing.

Practical advice

**Know whether you should be tested.** The main risk is blood-to-blood contact. That includes ever having injected drugs, even once and even decades ago; a blood transfusion in the UK before September 1991; medical or dental treatment in a country with less rigorous infection control; tattoos or piercings with unsterilised equipment; and sharing razors or toothbrushes with someone infected. Babies born to an infected mother can also acquire it. **If any of that applies, get a test even if you feel perfectly well.** That is the whole point. Most people with hepatitis C have no symptoms for years. **Testing is easy and free.** You can ask your GP. In England you can also order a free home testing kit through the NHS, and many drug and alcohol services and some pharmacies offer testing. If you have blood taken in A&E in many areas, you will be offered a hepatitis test automatically unless you say no. **Do not wait for symptoms.** When they do appear, they are vague — tiredness, aches, poor appetite, feeling sick. By the time there is obvious liver trouble, more damage has been done. **If you test positive, the outlook is good.** Modern tablets cure most people. Side effects are usually mild. Take the full course, and have the follow-up test afterwards that confirms the virus has gone. **You can be reinfected.** Being cured once does not protect you, so avoid sharing any equipment that could carry blood.

What to know

England has met the WHO treatment target for hepatitis C, with coverage at or above 80%, and must now hold it for two consecutive years for elimination to be confirmed. The remaining gap is diagnosis: an estimated 84.6% of people living with the virus have been diagnosed, against a 90% target. Progress has been substantial. Estimated chronic cases fell to about 50,200 in 2024, down 61.1% from 129,000 in 2015. The regional reports published this month show the national average hides real differences — treatment coverage of 75.1% in London against 85.2% in Yorkshire and the Humber. Rising case reports in several regions appear to reflect more testing rather than more infection, particularly since opt-out testing in emergency departments expanded in 2024. The single most useful thing an individual can do is get tested if any risk factor applies, however long ago and however well they feel. The treatment works. The obstacle is finding people. Sources: GOV.UK (UK Health Security Agency), "Hepatitis C in England 2025", https://www.gov.uk/government/publications/hepatitis-c-in-england-and-the-uk/hepatitis-c-in-england-2025. GOV.UK (UKHSA), "Hepatitis C in Yorkshire and Humber annual report 2025", page updated 21 October 2026, https://www.gov.uk/government/publications/hepatitis-c-in-yorkshire-and-humber-annual-reports/hepatitis-c-in-yorkshire-and-humber-annual-report-2025. GOV.UK (UKHSA), "Hepatitis C in London annual report 2025", https://www.gov.uk/government/publications/hepatitis-c-in-london-annual-reports/hepatitis-c-in-london-annual-report-2025. NHS, "Hepatitis C", https://www.nhs.uk/conditions/hepatitis-c/. This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional.

#hepatitis C#UKHSA#elimination#testing#liver health#public health

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