Nottingham Insight

Viral Hepatitis (2014)

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Topic title Viral Hepatitis (2014)
Topic owner Health Protection Strategy Group
Topic author(s) Libby Lomas
Topic quality reviewed 4th August 2014
Topic endorsed by Health Protection Strategy Group, September 2014
Topic approved by Health Protection Strategy Group, September 2014
Current version 17th September 2014
Replaces version 14th August 2014
Linked JSNA topics
Insight Document ID 107190

Executive summary


Hepatitis B and hepatitis C (HBV and HCV) are blood borne viral infections that can lead to chronic infection. Without treatment these infections can lead to cirrhosis of the liver and liver cancer therefore causing significant costs to the health of the individual and the services providing treatment and care.

Given the clinical and social manifestation of HBV and HCV (complex sometimes asymptomatic diseases often associated with vulnerable groups such as injecting drug users) infected individuals can often go undiagnosed. In turn this increases the risk of liver disease and death.

Prevention, early diagnosis, treatment and aftercare provide the framework for a comprehensive and robust strategic approach.

Unmet needs and gaps.

Lack of knowledge and awareness among professionals, the public and at risk groups.

  • Nationally and locally there is no agreement relating to how HBV and HCV awareness raising interventions across the settings should be implemented and monitored.
  • There is no agreed approach to diagnosing HBV and HCV. In addition there are no nationally or locally agreed treatment targets. Social and emotional aftercare needs have also not been fully scoped.
  • The improved HCV treatment offer is expected to increase demand and may challenge service design to include more community based clinics.
  • Pending confirmation from NHSE it is not clear what specialised commissioning will encompass and therefore unclear what CCGs will have to fund.
  • Data is fragmented and there is a lack of outcome data for monitoring purposes across the care pathway.

Recommendations for consideration by commissioners

Implement programmes to increase awareness among health professionals, the general public and those at increased risk.

  • Implement arrangements to systematically identify those at increased risk.
  • Promote and offer HBV and HCV testing and monitor those individuals who continue to put themselves at risk
  • Ensure geographically accessible and appropriately configured treatment services.
  • Assess the need for support measures (clinical, social and emotional) to be in place for improving outcomes following treatment.
  • Support the establishment of an East Midlands clinical network.

Key contacts

Jonathan Gribbin, Consultant in Public Health, Public Health Nottinghamshire County & Nottingham City

Libby Lomas, Public Health Manager, Public Health Nottinghamshire County & Nottingham City

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