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BackEntry title:

Hepatitis C individuals at each stage of treatment

Last updated on Thursday, 10 April 2025 at 03:30pm

Summary

Topic
Hepatitis-C
Category
headline
API name
hepatitis-c_headline_treatmentPathway

Rationale

Hepatitis C testing and treatment data has been used to follow individuals through the care pathway and identify gaps in care and/or monitoring.

Definition

The number of individuals testing positive for hepatitis C virus ribonucleic acid (RNA) or core antigen was based on the first hepatitis C virus RNA or core antigen positive test reported through Sentinel Surveillance of Blood Borne testing (SSBBV) during the period 2015 to 2023.

Linked treatment data was then used to follow individuals through the care pathway, including data from Operational Delivery Networks (ODNs) reported through the NHS England Hepatitis C Patient Registry and Treatment Outcome System and NHS England’s Blueteq System (which facilitates access to high-cost drugs for hepatitis C treatment).

The estimates are reliant on sufficient identifiers being available to link between the treatment and SSBBV databases and on the completion of data reported; data quality is assessed on an ongoing basis.

Caveats

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 NHS England’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 whose body has cleared the infection on its own or individuals who have cleared infection as a result of treatment but were not linked to the NHS England Hepatitis C Patient Registry and Treatment Outcome System or NHS England’s Blueteq System.

In the absence of a reported sustained virological response (SVR) as a treatment outcome in the NHS England 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.

In individuals with chronic hepatitis C who started treatment: 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 the body clearing the virus on its own.

In individuals linked to the treatment database: Numerator: number of individuals linked to specialist hepatitis C treatment services via ODNs (identified through successful linkage to the NHS England Hepatitis C Patient Registry and Treatment Outcome System and/or NHS England’s Blueteq system). 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.

In individuals who started treatment: Numerator: number starting treatment. Denominator: number of individuals linked to specialist hepatitis C treatment services via ODNs.

In individuals clearing hepatitis C virus: 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.

In individuals reporting a treatment outcome: Numerator: number of individuals who had a treatment outcome reported via the NHS England Hepatitis C Patient Registry and Treatment Outcome System, or in the absence of a recorded outcome, an RNA or core antigen test (positive or negative) recorded at 96 days or more after the treatment start date in SSBBV. Denominator: number of individuals who started treatment.

In individuals with a reported treatment outcome who cleared hepatitis C virus: 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. Denominator: number of individuals with a treatment outcome recorded or with an RNA or core antigen test (positive or negative) recorded at 96 days or more after the treatment start date in SSBBV.

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