Scotland’s Hepatitis C Action Plan: Achievements of the First Decade and Proposals for a Scottish Government Strategy (2019) for the Elimination of both Infection and Disease
Scotland’s Hepatitis C Action Plan, initiated during 2006‐8, has had an enormous impact on tackling one of Scotland’s major public health problems and has laid the foundations for the next equally ambitious phase of the Plan.
Between 2006 and 2018:
- A 45% reduction in the number of people living with chronic hepatitis C from an estimated 38,000 to 21000.
- A 55% reduction in the number of people unaware of their infection from 23,500 to 10500.
- Approximately 16,000 treated of whom an estimated 12,800 (80%) have cleared their virus.
In the Context of the Era of the Direct Acting Antiviral Therapies, available since 2014:
- New presentations of hepatitis C related decompensated cirrhosis (liver failure) declining 67% from a peak of 141 in 2013 to 47 in 2018.
- New presentations of hepatitis C related hepatocellular carcinoma declining 69% from a peak of 58 in 2016 to 18 in 2018.
- Hepatitis C related deaths declining 49% from a peak of 67 in 2015 to 34 in 2018.
The Following Strategy is Proposed
The elimination of hepatitis C infection and hepatitis C related severe disease and death as a major public health concern by 2024 at the latest.
Definition of Elimination:
- Hepatitis C Infection: 5,000 or less chronically infected people- i.e: no greater than 1 in 1,000 people of Scotland.
- Hepatitis C-related Liver Failure/Liver Cancer/Death: For each outcome, less than 10 people with chronic HCV presenting per year.
- Compliance with WHO Elimination Targets Targets, set by WHO in 2016, for the elimination of Hepatitis C to be achieved by 2030, will be met by the dates as above.