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Entry title:

Hepatitis C (HCV)

Last updated on Friday, 11 April 2025 at 04:26pm

Hepatitis C virus (HCV) is a bloodborne virus (BBV) that infects the liver and over time can cause severe liver damage leading to cirrhosis, liver failure and cancer.

Through the surveillance of chronic viral hepatitis, UKHSA monitor disease trends, identify populations disproportionately affected and inequities in access and outcomes of care.

Data reported by local (NHS or private) or reference laboratories on testing for viral hepatitis is the primary source of data.

In 2016, the UK signed up to the WHO global health sector strategy (GHSS) to eliminate viral hepatitis as a public health threat by 2030. To validate elimination of viral hepatitis, it is necessary to demonstrate the achievement of the WHO impact and programmatic targets. The impact targets include absolute thresholds for incidence and mortality, and programmatic targets focus on diagnosis, treatment and prevention.

The impact targets are:

  • Incidence less than or equal to 5 per 100,000 in all persons and less than or equal to 2 per 100 people who inject drugs.
  • Mortality less than or equal to 6 per 100,000 population for hepatitis C and hepatitis B combined. Previously, 2 per 100,000 persons for hepatitis C.

The programmatic targets are:

  • At least 90% of people living with chronic hepatitis C to be diagnosed.
  • At least 80% of people who are diagnosed with hepatitis C to be treated.
  • At least 300 needles and syringes provided per person who injects drugs per year or at least 40% of people who inject drugs who are dependent on opioids to be receiving OAT.
  • 100% of healthcare facilities with safe injections or 90% of healthcare injection devices procured to be safety-engineered.
  • 100% of blood donations to be screened.

We summarise England’s progress towards the WHO elimination targets for hepatitis C virus here and within the Hepatitis C in England Report. These metrics are updated annually. We will next update the data in March 2026.

Headlines

HCV prevalence estimates 2023 (aged 16 and over)

Up to 31 Dec 2023
55,900

Annual mortality rate of hepatitis C virus-related deaths per 100,000 population 2023 (WHO target: 2)

Up to 31 Dec 2023
0.4

Proportion of people diagnosed with hepatitis C initiating treatment (WHO Target: 80%)

Up to 31 Dec 2023
78.3%

Estimated proportion of people who inject drugs reporting adequate NSP

Up to 31 Dec 2023
66.1%

People who inject drugs who are dependent on opioids receiving OAT tax year 2019 to 2020 (WHO target: 40%)

Up to 31 Dec 2023
58.1%

Prevalence

Estimated prevalence in the general adult population in England, 2012 to 2023

Dotted line shows 95% credible interval (Crl). In England, around 55,900 adults aged 16 years and over (95% Crl, 44,200 to 69,900) were estimated to be living with chronic hepatitis C in 2023, equivalent to a prevalence estimate of 0.12% (95% Crl, 0.10% to 0.15%), a 56.7% decline when compared to 2015. Figures are annual, but shown as at December of each year. For example, the figures for 2022 are shown as at "Dec 2022".

Up to and including year ending 31 Dec 2023

ChartThere are 3 plots on this chart. The horizontal X-axis is labelled 'date'. Whilst the vertical Y-axis is labelled 'metric'. This is plot number 1 on this chart. This is a dark blue solid line plot. The plot has a label of 'Prevalence estimate'. This plot shows data for Hepatitis-C. Specifically the metric 'hepatitis-c_cases_prevalenceByYearEstimate' for the England area, along with the age banding of 'all' for the gender group of all. This plot shows data from 31 December 2012 to 31 December 2023. It fell from 145800.0 on 31 December 2012 to 139900.0 on 31 December 2013. It fell from 134300.0 on 31 December 2014 to 129000.0 on 31 December 2015. It fell from 119900.0 on 31 December 2016 to 108600.0 on 31 December 2017. It fell from 98300.0 on 31 December 2018 to 87900.0 on 31 December 2019. It fell from 78500.0 on 31 December 2020 to 70000.0 on 31 December 2021. And finally. It fell from 62300.0 on 31 December 2022 to 55900.0 on 31 December 2023. This is plot number 2 on this chart. This is a turquoise dash line plot. The plot has a label of 'Lower 95% credible interval'. This plot shows data for Hepatitis-C. Specifically the metric 'hepatitis-c_cases_prevalenceByYearLowerBound' for the England area, along with the age banding of 'all' for the gender group of all. This plot shows data from 31 December 2012 to 31 December 2023. It fell from 126000.0 on 31 December 2012 to 120400.0 on 31 December 2013. It fell from 115200.0 on 31 December 2014 to 109900.0 on 31 December 2015. It fell from 100700.0 on 31 December 2016 to 89500.0 on 31 December 2017. It fell from 79600.0 on 31 December 2018 to 70000.0 on 31 December 2019. It fell from 61600.0 on 31 December 2020 to 54900.0 on 31 December 2021. And finally. It fell from 48900.0 on 31 December 2022 to 44200.0 on 31 December 2023. This is plot number 3 on this chart. This is a turquoise dash line plot. The plot has a label of 'Upper 95% credible interval'. This plot shows data for Hepatitis-C. Specifically the metric 'hepatitis-c_cases_prevalenceByYearUpperBound' for the England area, along with the age banding of 'all' for the gender group of all. This plot shows data from 31 December 2012 to 31 December 2023. It fell from 162000.0 on 31 December 2012 to 157000.0 on 31 December 2013. It fell from 152100.0 on 31 December 2014 to 147000.0 on 31 December 2015. It fell from 138100.0 on 31 December 2016 to 126900.0 on 31 December 2017. It fell from 116600.0 on 31 December 2018 to 106000.0 on 31 December 2019. It fell from 96300.0 on 31 December 2020 to 86600.0 on 31 December 2021. And finally. It fell from 77800.0 on 31 December 2022 to 69900.0 on 31 December 2023. There is no reporting delay period being tracked for the data on this chart. - Refer to tabular data.
Tabular data

Estimated prevalence in the general adult population in England, 2012 to 2023 data for dotted line shows 95% credible interval (Crl).

In England, around 55,900 adults aged 16 years and over (95% Crl, 44,200 to 69,900) were estimated to be living with chronic hepatitis C in 2023, equivalent to a prevalence estimate of 0.12% (95% Crl, 0.10% to 0.15%), a 56.7% decline when compared to 2015.

Figures are annual, but shown as at December of each year. For example, the figures for 2022 are shown as at "Dec 2022".

Up to and including 31 December 2023

YearPrevalence estimateLower 95% credible interval
31 Dec 202355,90044,200
31 Dec 202262,30048,900
31 Dec 202170,00054,900
31 Dec 202078,50061,600
31 Dec 201987,90070,000
31 Dec 201898,30079,600
31 Dec 2017108,60089,500
31 Dec 2016119,900100,700
31 Dec 2015129,000109,900
31 Dec 2014134,300115,200
31 Dec 2013139,900120,400
31 Dec 2012145,800126,000
YearUpper 95% credible interval
31 Dec 202369,900
31 Dec 202277,800
31 Dec 202186,600
31 Dec 202096,300
31 Dec 2019106,000
31 Dec 2018116,600
31 Dec 2017126,900
31 Dec 2016138,100
31 Dec 2015147,000
31 Dec 2014152,100
31 Dec 2013157,000
31 Dec 2012162,000
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Source: Modelled estimates of chronic hepatitis C prevalence based on multiple sources of information. Further information can be found in Technical notes. NOTES: Note 1: The model calculates the proportion of people living with chronic hepatitis C out of all those alive who have ever had hepatitis C (that is people who are hepatitis C virus antibody positive). The latter may have cleared their infection through achieving a sustained virological response (SVR) post treatment, or through spontaneous clearance. Note 2: The model assumes that the proportion of people who spontaneously cleared hepatitis C without treatment is a fixed quantity with no uncertainty (24% of infections spontaneously clear without treatment). Therefore prior to DAA treatment, the CrI for the proportion of chronic infections is very narrow. Note 3: The model estimates the percentage of the adult (aged 16 years and over) population with chronic hepatitis C infection. Virtually all infections are in those aged 16 years and over, so a more accurate picture is given by excluding children from the denominator.

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Deaths

Mortality rate for hepatitis C virus-related End-Stage Liver Disease (ESLD) and/or hepatocellular carcinoma (HCC) in England, 2005 to 2023

The hepatitis C target has been met, with the annual hepatitis C virus-related ESLD and/or HCC mortality rate at 0.41 per 100,000 population in 2023. Figures are annual, but shown as at December of each year. For example, the figures for 2022 are shown as at "Dec 2022".

Up to and including year ending 31 Dec 2023

ChartThere are 2 plots on this chart. The horizontal X-axis is labelled 'date'. Whilst the vertical Y-axis is labelled 'metric'. This is plot number 1 on this chart. This is a dark blue solid line plot. The plot has a label of 'Rate for hepatitis C virus-related HCC and/or ESLD'. This plot shows data for Hepatitis-C. Specifically the metric 'hepatitis-c_deaths_rateByYear' for the England area, along with the age banding of 'all' for the gender group of all. This plot shows data from 31 December 2005 to 31 December 2023. It rose from 0.36 on 31 December 2005 to 0.45 on 31 December 2008. It rose from 0.52 on 31 December 2009 to 0.55 on 31 December 2011. It rose from 0.67 on 31 December 2012 to 0.7 on 31 December 2014. It fell from 0.69 on 31 December 2015 to 0.57 on 31 December 2017. It fell from 0.55 on 31 December 2018 to 0.47 on 31 December 2020. And finally. It fell from 0.48 on 31 December 2021 to 0.42 on 31 December 2023. This is plot number 2 on this chart. This is a turquoise dash line plot. The plot has a label of 'WHO 2023 absolute elimination target'. This plot shows data for Hepatitis-C. Specifically the metric 'hepatitis-c_deaths_WHOmortalityTarget' for the England area, along with the age banding of 'all' for the gender group of all. This plot shows data from 31 December 2005 to 31 December 2023. The date fluctuates between 2.0 on 31 December 2005, ending with the same value on 31 December 2008. The date fluctuates between 2.0 on 31 December 2009, ending with the same value on 31 December 2011. The date fluctuates between 2.0 on 31 December 2012, ending with the same value on 31 December 2014. The date fluctuates between 2.0 on 31 December 2015, ending with the same value on 31 December 2017. The date fluctuates between 2.0 on 31 December 2018, ending with the same value on 31 December 2020. And finally. The date fluctuates between 2.0 on 31 December 2021, ending with the same value on 31 December 2023. There is no reporting delay period being tracked for the data on this chart. - Refer to tabular data.
Tabular data

Mortality rate for hepatitis C virus-related End-Stage Liver Disease (ESLD) and/or hepatocellular carcinoma (HCC) in England, 2005 to 2023 data for the hepatitis C target has been met, with the annual hepatitis C virus-related ESLD and/or HCC mortality rate at 0.41 per 100,000 population in 2023.

Figures are annual, but shown as at December of each year. For example, the figures for 2022 are shown as at "Dec 2022".

Up to and including 31 December 2023

YearRate for hepatitis C virus-related HCC and/or ESLDWHO 2023 absolute elimination target
31 Dec 20230.422
31 Dec 20220.442
31 Dec 20210.482
31 Dec 20200.472
31 Dec 20190.52
31 Dec 20180.552
31 Dec 20170.572
31 Dec 20160.672
31 Dec 20150.692
31 Dec 20140.72
31 Dec 20130.672
31 Dec 20120.672
31 Dec 20110.552
31 Dec 20100.52
31 Dec 20090.522
31 Dec 20080.452
31 Dec 20070.422
31 Dec 20060.362
31 Dec 20050.362
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Source: Based on Office for National Statistics (ONS) mid-year population estimates for the UK, England, Wales, Scotland, and Northern Ireland. Notes: Note 1: Death registrations for England are those where hepatitis C is mentioned on the death certificate and excludes deaths registered in England where the deceased’s usual residence is outside of England. Note 2: Defined by codes or text entries for ascites, bleeding oesophageal varices, hepato-renal syndrome, hepatic encephalopathy, or hepatic failure (see link below for further information).

Treatment

81.4% of individuals diagnosed with chronic hepatitis C were linked to specialist treatment services.

96.1% of individuals linked to specialist treatment services initiated treatment.

78.3% of individuals diagnosed with chronic hepatitis C initiated treatment (WHO target).

90.9% of individuals who initiated treatment had an outcome reported or had an RNA or core antigen test reported through SSBBV.

83.1% of individuals who initiated treatment were reported to have achieved SVR either as a treatment outcome or had an RNA or core antigen negative result reported through SSBBV.

91.5% of individuals who initiated treatment and had an outcome reported or an RNA or core antigen test reported through SSBBV were reported to have achieved SVR or had an RNA or core antigen negative test result.

Hepatitis C treatment pathway in England, 2015 to 2023

Between 2015 and 2023, 111,579 individuals had a hepatitis C virus RNA or core antigen positive test result reported in Sentinel Surveillance of Blood Borne Virus testing (SSBBV). Through linking to the NHSE Hepatitis C Patient Registry and Treatment Outcome System and/or NHSE’s Blueteq reports, where NHS number or name and date of birth were available, 78.3% were recorded as initiating treatment. The full titles of each bar should read: "Individuals with chronic HCV", "Individuals with Chronic HCV and NHS number of name and date of birth", "Linked with treatment database", "Treatment started (post RNA positive)", "Outcome reported", "Sustained virologic response". Data to end of 2023.

Up to and including 31 Dec 2023

ChartThere are 6 plots on this chart. The horizontal X-axis is labelled 'stratum'. Whilst the vertical Y-axis is labelled 'metric'. This is plot number 1 on this chart. This is a dark blue solid bar plot. This plot shows data for Hepatitis-C. Specifically the metric 'hepatitis-c_headline_treatmentPathway' for the England area, along with the age banding of 'all' for the gender group of all. This plot shows `Individuals with chronic HCV` along the X-axis. And `111579.0000` along the Y-axis. This is plot number 2 on this chart. This is a dark blue solid bar plot. This plot shows data for Hepatitis-C. Specifically the metric 'hepatitis-c_headline_treatmentPathway' for the England area, along with the age banding of 'all' for the gender group of all. This plot shows `Chronic HCV and valid identifiers` along the X-axis. And `83071.0000` along the Y-axis. This is plot number 3 on this chart. This is a dark blue solid bar plot. This plot shows data for Hepatitis-C. Specifically the metric 'hepatitis-c_headline_treatmentPathway' for the England area, along with the age banding of 'all' for the gender group of all. This plot shows `Linked with treatment database` along the X-axis. And `62328.0000` along the Y-axis. This is plot number 4 on this chart. This is a dark blue solid bar plot. This plot shows data for Hepatitis-C. Specifically the metric 'hepatitis-c_headline_treatmentPathway' for the England area, along with the age banding of 'all' for the gender group of all. This plot shows `Treatment started` along the X-axis. And `57689.0000` along the Y-axis. This is plot number 5 on this chart. This is a dark blue solid bar plot. This plot shows data for Hepatitis-C. Specifically the metric 'hepatitis-c_headline_treatmentPathway' for the England area, along with the age banding of 'all' for the gender group of all. This plot shows `Outcome reported` along the X-axis. And `53651.0000` along the Y-axis. This is plot number 6 on this chart. This is a dark blue solid bar plot. This plot shows data for Hepatitis-C. Specifically the metric 'hepatitis-c_headline_treatmentPathway' for the England area, along with the age banding of 'all' for the gender group of all. This plot shows `Sustained virological response` along the X-axis. And `47755.0000` along the Y-axis. There is no reporting delay period being tracked for the data on this chart. - Refer to tabular data.
Tabular data

Hepatitis C treatment pathway in England, 2015 to 2023 data for between 2015 and 2023, 111,579 individuals had a hepatitis C virus RNA or core antigen positive test result reported in Sentinel Surveillance of Blood Borne Virus testing (SSBBV). Through linking to the NHSE Hepatitis C Patient Registry and Treatment Outcome System and/or NHSE’s Blueteq reports, where NHS number or name and date of birth were available, 78.3% were recorded as initiating treatment. The full titles of each bar should read: "Individuals with chronic HCV", "Individuals with Chronic HCV and NHS number of name and date of birth", "Linked with treatment database", "Treatment started (post RNA positive)", "Outcome reported", "Sustained virologic response".

Data to end of 2023.

Up to and including 31 December 2023

StratumAmount
Individuals with chronic HCV111,579
Chronic HCV and valid identifiers83,071
Linked with treatment database62,328
Treatment started57,689
Outcome reported53,651
Sustained virological response47,755
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Sources: Sentinel Surveillance of Blood Borne Virus testing (SSBBV) , NHSE Hepatitis C Patient Registry and Treatment Outcome System and NHSE Blueteq reports of direct acting antivirals for hepatitis C. NOTES: Note 1: In individuals testing hepatitis C virus RNA or core antigen positive with no linkage to the Hepatitis C Patient Registry and Treatment Outcome System or NHSE’s Blueteq System, there are no time restrictions on a subsequent RNA or core antigen negative test after the initial RNA or core antigen positive test. Therefore, these individuals may include those that have spontaneous clearance of their infection or individuals who have cleared infection as a result of treatment but were not linked to the NHSE Hepatitis C Patient Registry and Treatment Outcome System or NHSE’s Blueteq System. Note 2: In the absence of a reported SVR as a treatment outcome in the NHSE Hepatitis C Patient Registry and Treatment Outcome System, an RNA or core antigen negative test recorded at 96 days or more after the treatment start date in SSBBV was used. Note 3: Numerator: number starting treatment. Denominator: number of individuals who tested positive for hepatitis C virus RNA or core antigen with NHS number or name and date of birth reported through SSBBV who had not died before linkage to treatment and where there was no evidence of possible spontaneous clearance. Note 4: Numerator: number clearing hepatitis C virus as a treatment outcome, or in the absence of a reported SVR, an RNA or core antigen negative test recorded at 96 days or more after the treatment start date in SSBBV. The proportion reported as clearing hepatitis C virus is likely to be lower than the true proportion. Denominator: number starting treatment.

Prevention

Estimated proportion of people who inject drugs reporting adequate needle and syringe provision (NSP) in England, 2017 to 2023

In 2023, 66.1% of people who injected drugs in the past year reported having adequate needle and syringe provision (NSP) for their needs. This figure is similar to previous years and highlights that 1 in 3 people continue to report inadequate NSP for their needs. Figures are annual, but shown as at December of each year. For example, the figures for 2022 are shown as at "Dec 2022".

Up to and including year ending 31 Dec 2023

ChartThere is only 1 plot on this chart. The horizontal X-axis is labelled 'date'. Whilst the vertical Y-axis is labelled 'metric'. This is a dark blue solid line plot. This plot shows data for Hepatitis-C. Specifically the metric 'hepatitis-c_prevention_PWIDproportionNSP' for the England area, along with the age banding of 'all' for the gender group of all. This plot shows data from 31 December 2017 to 31 December 2023. It rose from 64.9 on 31 December 2017 to 68.2 on 31 December 2018. The date fluctuates between 66.1 on 31 December 2019, ending with the same value on 31 December 2019. The date fluctuates between 62.7 on 31 December 2020, ending with the same value on 31 December 2020. The date fluctuates between 65.6 on 31 December 2021, ending with the same value on 31 December 2021. The date fluctuates between 68.1 on 31 December 2022, ending with the same value on 31 December 2022. And finally. The date fluctuates between 66.1 on 31 December 2023, ending with the same value on 31 December 2023. There is no reporting delay period being tracked for the data on this chart. - Refer to tabular data.
Tabular data

Estimated proportion of people who inject drugs reporting adequate needle and syringe provision (NSP) in England, 2017 to 2023 data for in 2023, 66.1% of people who injected drugs in the past year reported having adequate needle and syringe provision (NSP) for their needs. This figure is similar to previous years and highlights that 1 in 3 people continue to report inadequate NSP for their needs.

Figures are annual, but shown as at December of each year. For example, the figures for 2022 are shown as at "Dec 2022".

Up to and including 31 December 2023

YearProportion (%)
31 Dec 202366.1
31 Dec 202268.1
31 Dec 202165.6
31 Dec 202062.7
31 Dec 201966.1
31 Dec 201868.2
31 Dec 201764.9
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Source: The Unlinked Anonymous Monitoring (UAM) Survey of infections and risk among people who inject drugs. Notes: Note 1: NSP is considered ‘adequate’ when the reported number of needles received met or exceeded the number of times the individual reported injecting in the past month. Note 2: During 2020 and 2021, recruitment to the UAM Survey was impacted by the COVID-19 pandemic. As a result, there were changes in the geographic and demographic profile of people taking part. This should be taken into account when interpreting data for these years.

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