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Testing is helping to tackle the hepatitis C virus

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There’s one deadly infection that we can beat – the virus that causes hepatitis C. This liver disease-causing virus was on a global rampage a decade ago, but is being pushed back in some countries by mass testing and treatment, according to new figures.

Egypt, once the country with the highest prevalence of this virus, is on course to slash infection rates by 2020, eliminating hepatitis C as a public health threat as defined by the World Health Organization.

And in the UK, cases have fallen by two thirds in one of the worst-affected groups, HIV-positive gay men. The trends are likely to be happening in other countries that employ this strategy too, says Lucy Garvey at St Mary’s Hospital in London.


The hepatitis C virus, which can cause liver failure and cancer, is mainly passed on by sex and drug users sharing needles. In the past it was widely spread by health care staff reusing needles too.

Practical curative treatments arrived a few years ago, but the drugs were initially too costly for most – one of the first cost $1000 a tablet – then cheap generic versions arrived.

Egypt has led the way in their use. Until recently, one in ten adults in the country had the virus, as a result of past mass treatment campaigns against parasitic worms where needles were reused.

In 2018 the country began voluntary screening of all adults with free tests and treatment. By last year, 80 per cent of the country had taken part and over 2 million had been treated.

If trends continue, the infection rate is set to fall to under 0.5 per cent of the population this year, according to figures out this month in The New England Journal of Medicine.

Some developed countries with low infection rates in the general population are targeting high-risk groups, such as people who are HIV-positive or who inject drugs – an approach called “micro-elimination” – by offering frequent testing.

In one of the first studies to show the effectiveness of this strategy, new infections fell by 68 per cent between 2015 and 2018 among HIV-positive gay men attending five clinics in London and Brighton. “It shows we’re on the right track,” says Garvey.

Journal reference: The New England Journal of Medicine,DOI: 10.1056/nejmsr1912628; Clinical Infectious Diseases, DOI: 10.1093/cid/ciaa021

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