Guidance

Hepatitis C in Yorkshire and Humber annual report 2025

Updated 8 October 2026

Introduction

Hepatitis C virus (HCV) is a bloodborne virus. Chronic infection can lead to liver cirrhosis, end-stage liver disease and liver cancer. Prevention and treatment efforts have been combined to combat HCV infection and progress towards elimination of HCV as a public health threat by 2030 (set out in the World Health Organization Global Health Sector Strategy on Viral Hepatitis). The National Strategic Group on Viral Hepatitis, a cross-agency expert advisory body supported by the UK Health Security Agency (UKHSA) provides strategic guidance on viral hepatitis in England and supports progress toward achieving the WHO goal of HCV elimination.

UKHSA publishes a national Hepatitis C in England report which summarises England’s progress towards the WHO elimination targets for HCV infection. This regional spotlight report complements the ‘Hepatitis C in England’ report and presents further information on HCV disease surveillance, and trends in HCV diagnosis, testing and treatment in Yorkshire and Humber UKHSA region with data up to end of 2024.

For more details about data sources, see Information on data sources.

Summary

New laboratory-confirmed diagnoses

Key findings for hepatitis C testing:

• there were 1,514 new laboratory reports of hepatitis C in residents of the Yorkshire and Humber UKHSA region, representing a rate of 26.7 reports per 100,000 population in 2024
• the number of new laboratory reports has increased by 21.8% since 2023 and decreased by 16.4% over the past 10 years
• in 2024, the number of positive laboratory reports by upper tier local authority of residence ranged from 18 in North Lincolnshire to 356 in Leeds. Rates were highest in Wakefield at 87.0 and lowest in East Riding of Yorkshire with 7.3
• in 2024, the number of laboratory reports in males was 760 (50.2%) and in females was 399 (26.4%). Sex was unknown in 23.4% of cases
• in 2024, the highest number of laboratory reports in females was in the 35 to 44 age group (133 laboratory reports) and in males was in both the 35 to 44 age group (234 laboratory reports) and the 45 to 54 age group (230 laboratory reports)
• there have been 49,731 individuals tested for anti-HCV in sentinel laboratories in Yorkshire and Humber UKHSA region in 2024, of which 1.9% tested positive
• the proportion positive was lower for tests referred from general practitioner (GP) surgeries (0.6%), lower for tests from sexual health services (0.9%), lower for tests referred from emergency departments (ED) (0.4%) and higher for tests from drug services (16.5%)

Key finding for hepatitis C treatment pathway:

• of 7,706 individuals with chronic hepatitis C linked to specialist treatment services (via the NHSE Hepatitis C Patient Registry and Treatment Outcome System and/or NHSE’s Blueteq System), 7,446 started treatment within 90 days and 6,581 achieved a sustained viral response (SVR), in Yorkshire and Humber UKHSA region between 2015 and 2024

Key findings for HCV-related morbidity and mortality:

• estimated hospital admissions for individuals with hepatitis C-related end-stage liver disease (ESLD) and/or hepatocellular carcinoma (HCC) in the Yorkshire and Humber UKHSA region in 2024 ranged from 96 to 131 admissions, similar to 2023
• estimated deaths from hepatitis C-related end-stage liver disease (ESLD) and/or hepatocellular carcinoma (HCC) in the Yorkshire and Humber UKHSA region were between 24 and 56 in 2024, compared with 20 to 48 estimated deaths in 2023

Trends in HCV testing and diagnosis in the general population and risk groups

The following tables and charts are derived from laboratory surveillance data. Laboratory reports reflect testing and reporting activity as well as underlying infection patterns, and trends may be influenced by changes in testing, screening and service provision. As these factors vary over time and between geographical areas, comparisons should be made with caution. For hepatitis C, new laboratory reports represent diagnosed infections rather than new infections and should not be interpreted as a direct measure of incidence.

New laboratory-confirmed diagnoses of HCV

Figure 1. Number of new laboratory reports of hepatitis C, residents of Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: Second Generation Surveillance System (SGSS). For more information, see Information on data sources.

Note 1: in 2022, a new bloodborne virus (BBV) testing programme was introduced in selected emergency department (ED) sites in areas of very high and high human immunodeficiency virus (HIV) diagnosed prevalence across England. This programme expanded to other areas of high HIV prevalence in the second phase of the implementation of this programme, starting in 2024, however, not all UKHSA regions had participating ED sites within their areas.

There were 1,514 new laboratory reports of hepatitis C in Yorkshire and Humber in 2024, a 21.8% increase from 1,243 in 2023. This likely reflects both true increases in testing opportunities (for example, ED opt-out) and ongoing service recovery across primary care and SHS. Between 2015 and 2024 new laboratory reports of HCV ranged from 1,035 reports in 2020 (reflecting disruption to testing and healthcare services during the COVID-19 pandemic) to a high of 1,812 reports in 2015.

Figure 2. Rate per 100,000 population of new laboratory reports of hepatitis C, residents of Yorkshire and Humber UKHSA region and England, 2015 to 2024

Data sources: SGSS and Office for National Statistics (ONS) mid-year population estimates (MYE). For more information, see Information on data sources.

Note 2: the error bands represent 95% confidence intervals.

The rate of new laboratory reports in Yorkshire and Humber increased from 22.2 per 100,000 population to 26.7 per 100,000 population in 2024. Since 2022, nationally funded ED opt-out programmes have become an important additional route to diagnosis in England and has contributed substantially to BBV testing and newly identified HCV infections nationally. Two trusts in Yorkshire and Humber (Leeds Teaching Hospitals NHS Trust and Sheffield Teaching Hospitals NHS Foundation Trust) were enrolled in this scheme towards the end of 2024.

Table 1. Number and rate per 100,000 population of new laboratory reports of hepatitis C by UKHSA region of residence and England, 2015 to 2024

Area		2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
East Midlands	Count	963	1,079	1,124	1,341	1,345	709	971	1,027	870	1,345
East Midlands	Rate	20.6	22.8	23.5	27.8	27.8	14.6	19.9	20.8	17.4	26.6
East of England	Count	1,105	1,291	1,131	1,039	1,072	773	1,092	997	815	929
East of England	Rate	16.6	19.2	16.7	15.3	15.7	11.3	15.8	14.3	11.5	12.9
London	Count	4,026	4,177	3,432	3,146	2,634	2,438	2,702	3,533	4,093	4,552
London	Rate	46.5	47.8	39.1	35.6	29.6	27.5	30.7	39.8	45.5	50.1
North East	Count	216	228	390	750	967	700	903	1,071	777	888
North East	Rate	8.3	8.7	14.9	28.5	36.7	26.5	34.1	39.9	28.5	32.2
North West	Count	2,935	2,625	2,485	3,467	2,964	1,462	2,782	2,693	2,826	2,767
North West	Rate	40.9	36.3	34.2	47.4	40.3	19.8	37.5	35.8	37.0	35.8
South East	Count	1,581	1,818	1,436	1,445	1,491	1,216	1,749	2,140	2,277	1,781
South East	Rate	18.8	21.4	16.8	16.8	17.3	14.0	20.1	24.3	25.5	19.7
South West	Count	1,147	1,065	1,105	994	957	913	842	947	1,035	1,400
South West	Rate	21.0	19.3	19.8	17.7	17.0	16.1	14.7	16.4	17.8	23.8
West Midlands	Count	1,090	1,371	1,198	1,118	1,305	922	1,221	1,141	794	1,161
West Midlands	Rate	18.9	23.6	20.5	19.0	22.0	15.5	20.5	19.0	13.0	18.8
Yorkshire and Humber	Count	1,812	1,483	1,423	1,608	1,665	1,035	1,314	1,258	1,243	1,514
Yorkshire and Humber	Rate	33.7	27.4	26.2	29.5	30.5	18.9	24.0	22.7	22.2	26.7
England	Count	14,916	15,182	14,517	16,195	15,864	10,630	14,116	15,217	15,432	16,590
England	Rate	27.2	27.5	26.1	29.0	28.2	18.9	25.0	26.6	26.6	28.3

Data sources: SGSS and Office for National Statistics (ONS) mid-year population estimates (MYE). For more information, see Information on data sources.

Note 3: Data was not available to assign a case to a UKHSA region in 253 cases, meaning that the sum of all regional cases may not equal the number of England cases.

In 2024, Yorkshire and Humber recorded 1,514 laboratory reports, a rate of 26.7 per 100,000 population. This was the fourth-highest regional rate after London (50.1), the North West (35.8) and the North East (32.2) but was below the England rate of 28.3 per 100,000. Regional comparisons should consider differences in testing coverage, targeted case-finding activity and the completeness of geographic information.

Table 2. Number and rate per 100,000 population of new laboratory reports of hepatitis C by upper tier local authority of residence, 2015 to 2024

Area		2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Barnsley	Count	7	8	64	79	50	20	40	41	43	32
Barnsley	Rate	2.9	3.3	26.5	32.6	20.5	8.2	16.3	16.6	17.3	12.7
Bradford	Count	16	6	107	178	176	109	160	227	105	96
Bradford	Rate	3.0	1.1	19.8	32.8	32.2	19.9	29.3	41.2	18.8	17.0
Calderdale	Count	2	1	20	28	33	14	32	25	33	26
Calderdale	Rate	1.0	0.5	9.6	13.5	15.9	6.8	15.5	12.0	15.8	12.3
Doncaster	Count	58	63	134	118	131	74	78	108	98	110
Doncaster	Rate	19.1	20.6	43.6	38.3	42.5	24.0	25.3	34.7	31.1	34.4
East Riding of Yorkshire	Count	46	42	46	62	42	32	39	41	20	26
East Riding of Yorkshire	Rate	13.7	12.5	13.7	18.4	12.4	9.4	11.4	11.8	5.7	7.3
Kingston upon Hull	Count	255	249	187	177	297	220	53	68	99	99
Kingston upon Hull	Rate	97.1	93.8	69.9	66.0	110.5	82.2	19.9	25.3	36.3	35.9
Kirklees	Count	34	23	77	96	103	54	73	151	59	40
Kirklees	Rate	7.9	5.3	17.8	22.1	23.8	12.5	16.8	34.4	13.3	8.9
Leeds	Count	9	5	216	286	303	164	189	184	287	356
Leeds	Rate	1.2	0.6	27.2	35.9	37.7	20.3	23.3	22.4	34.4	42.1
North East Lincolnshire	Count	16	20	29	41	21	18	26	22	19	22
North East Lincolnshire	Rate	10.1	12.6	18.3	25.9	13.3	11.4	16.5	13.9	12.0	13.8
North Lincolnshire	Count	42	38	70	52	27	18	26	31	12	18
North Lincolnshire	Rate	24.8	22.3	41.0	30.5	15.9	10.6	15.3	18.2	7.0	10.5
North Yorkshire	Count	59	16	48	56	45	50	40	31	39	52
North Yorkshire	Rate	9.8	2.6	7.9	9.2	7.4	8.2	6.5	5.0	6.2	8.2
Rotherham	Count	29	19	39	62	102	82	163	178	41	53
Rotherham	Rate	11.1	7.2	14.8	23.4	38.3	30.9	61.2	66.2	15.0	19.2
Sheffield	Count	334	199	266	252	222	103	73	62	149	231
Sheffield	Rate	60.2	35.8	47.9	45.3	39.9	18.6	13.2	11.0	25.9	39.7
Wakefield	Count	228	244	63	59	78	55	67	61	224	320
Wakefield	Rate	68.3	72.3	18.5	17.1	22.4	15.7	18.9	17.0	61.7	87.0
York	Count	673	548	52	40	32	19	22	13	13	28
York	Rate	331.2	270.1	25.5	19.6	15.7	9.4	10.9	6.3	6.3	13.4
No UTLA data available	Count	4	2	5	22	3	3	233	15	2	5
No UTLA data available	Rate	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
England	Count	14,916	15,182	14,517	16,195	15,864	10,630	14,116	15,217	15,432	16,590
England	Rate	27.2	27.5	26.1	29.0	28.2	18.9	25.0	26.6	26.6	28.3

Data sources: SGSS and Office for National Statistics (ONS) mid-year population estimates (MYE). For more information, see Information on data sources.

Note 4: Data was not available to assign a case to a UKHSA region in 253 cases, meaning that the sum of all regional cases may not equal the number of England cases. UTLA data was available for 98% of cases where region data was available.

There was substantial variation between upper tier local authorities (UTLA) in 2024, with counts ranging from 18 in North Lincolnshire to 356 in Leeds. Wakefield had the highest rate of laboratory reports (87.0 per 100,000 population), substantially above the England rate of 28.3 per 100,000 population. Leeds (42.1), Sheffield (39.7), Kingston upon Hull (35.9) and Doncaster (34.4) also had rates above the England rate. In contrast, the lowest rates were observed in East Riding of Yorkshire (7.3 per 100,000 population), North Yorkshire (8.2 per 100,000 population) and Kirklees (8.9 per 100,000 population).

Figure 3. Age group and sex of new laboratory reports of hepatitis C, residents of Yorkshire and Humber UKHSA region, 2024

Data source: Second Generation Surveillance System (SGSS). For more information, see Information on data sources.

Males accounted for substantially more laboratory reports than females in every age group in 2024, except among those aged 1 to 24 years (20 males and 19 females) and 65 years and over (55 females and 37 males). The greatest number of reports was among people aged 35 to 44 years, including 234 males and 133 females. Males aged 45 to 54 years also accounted for large numbers of reports (n=230).

Figure 4. Ethnicity distribution of new laboratory reports of hepatitis C, residents of Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: SGSS. For more information, see Information on data sources.

Note 5: this figure excludes cases of unknown ethnicity (36.2% of reports had no ethnicity recorded).

Note 6: where the number of cases in an ethnic group in a given year is between 1 and 4 (inclusive), data has been suppressed for disclosure control. Suppressed values are shown as an asterisk (*) on the chart.

White British people accounted for most reports with known ethnicity between 2015 and 2024, however, the proportion has steadily declined from 75.8% in 2020 to 64.8% in 2024. The proportion among Asian or Asian British people increased to 14.7% in 2024, the highest value in the period. Interpretation is limited because ethnicity was not recorded for 36.1% of reports.

HCV testing in the wider population

Figure 5. Number of individuals tested for anti-HCV by year and percentage positive in sentinel laboratories in Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: SSBBV. For more information, see Information on data sources.

Note 7: trend data only includes testing laboratories that have consistently reported over time. Results from laboratories that report results on an inconsistent or temporary basis are excluded so as not to skew trends.

Note 8: in 2022, a new bloodborne virus (BBV) testing programme was introduced in selected emergency department (ED) sites in areas of very high and high human immunodeficiency virus (HIV) diagnosed prevalence across England. This programme expanded to other areas of high HIV prevalence in the second phase of the implementation of this programme, starting in 2024, however, not all UKHSA regions had participating ED sites within their areas.

Note 9: the error bands represent 95% confidence intervals.

A total of 49,731 individuals were tested for anti-HCV in sentinel laboratories in 2024, a 23.7% increase compared to 40,205 in 2023. The number of individuals tested has increased over the past decade, rising from 23,403 in 2015. The proportion positive fell from 2.5% in 2023 to 1.9% in 2024.

Since 2022, the ED opt‑out programme has become an important additional route to diagnosis in England and has contributed substantially to BBV testing and newly identified HCV infections nationally. Although no trusts in Yorkshire and Humber were included in the first round of the initiative, 2 trusts began opt-out BBV testing as part of the programme expansion towards the end of 2024. One of these trusts is a sentinel laboratory, which may have contributed to some of the increase observed.

Numbers tested and positivity rates according to service-type (GP, SHS, people-who-inject drugs and/or drug services and EDs) are presented in Figures 6 to 9. Positivity among tests referred through drug services remained substantially higher than that seen in other testing settings (16.5%), reflecting the targeted testing of populations at increased risk of HCV infection. Positivity among sexual health services, GP surgeries and EDs was 0.9%, 0.6% and 0.4%, respectively. Trends should be interpreted with caution within the different settings as they may be due to changes in testing activities and only a subset of tests being sent to sentinel laboratories.

Figure 6. Number of individuals tested for anti-HCV by year and percentage positive, through GP surgeries, in sentinel laboratories in Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: SSBBV. For more information, see Information on data sources.

Note 10: trend data only includes testing laboratories that have consistently reported over time. Results from laboratories that report results on an inconsistent or temporary basis are excluded so as not to skew trends.

Note 11: the error bands represent 95% confidence intervals.

GP-referred anti-HCV testing has been increasing since 2015 (7,268) with 13,925 individuals tested in 2024, although numbers remained similar to 2023 (13,868). The proportion positive was 0.6%, unchanged from 2023. Positivity among GP-referred tests was lower than both the overall positivity rate and that observed in drug service, consistent with testing being undertaken in populations at lower risk of HCV infection.

Figure 7. Number of individuals tested for anti-HCV by year and percentage positive, through sexual health services, in sentinel laboratories in Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: SSBBV. For more information, see Information on data sources.

Note 12: trend data only includes testing laboratories that have consistently reported over time. Results from laboratories that report results on an inconsistent or temporary basis are excluded so as not to skew trends.

Note 13: the error bands represent 95% confidence intervals.

SHS-referred anti-HCV testing has also been increasing since 2015 (2,296) with 3,608 individuals tested in 2024, an increase of 14.8% from 2023 (3,143). The proportion positive was 0.9%, unchanged from 2023 and 2015. Positivity among SHS-referred tests was lower than both the overall positivity rate and that observed in drug service, consistent with testing being undertaken in populations at lower risk of HCV infection.

Figure 8. Number of individuals tested for anti-HCV by year and percentage positive, through drug services, in sentinel laboratories in Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: SSBBV. For more information, see Information on data sources.

Note 14: trend data only includes testing laboratories that have consistently reported over time. Results from laboratories that report results on an inconsistent or temporary basis are excluded so as not to skew trends.

Note 15: the error bands represent 95% confidence intervals.

Drug service-referred anti-HCV testing has also been increasing since 2015 (488) with 3,744 individuals tested in 2024, an increase of 3.3% from 3,625 in 2023.

Positivity among tests referred through drug services remained substantially higher than that seen in other testing settings, reflecting the targeted testing of populations at increased risk of HCV infection.

Figure 9. Number of individuals tested for anti-HCV by year and percentage positive, through emergency departments, in sentinel laboratories in Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: SSBBV. For more information, see Information on data sources.

Note 16: trend data only includes testing laboratories that have consistently reported over time. Results from laboratories that report results on an inconsistent or temporary basis are excluded so as not to skew trends.

Note 17: in 2022, a new bloodborne virus (BBV) testing programme was introduced in selected emergency department (ED) sites in areas of very high and high human immunodeficiency virus (HIV) diagnosed prevalence across England. This programme expanded to other areas of high HIV prevalence in the second phase of the implementation of this programme, starting in 2024, however, not all UKHSA regions had participating ED sites within their areas.

Note 18: the error bands represent 95% confidence intervals.

ED-referred anti-HCV testing increased by 140.6% from 4,752 individuals in 2023 to 11,433 in 2024. The opt-out ED BBV testing programme was scaled-up to include 2 trusts in Yorkshire and Humber towards the end of 2024 (Leeds Teaching Hospitals NHS Trust and Sheffield Teaching Hospitals NHS Foundation Trust). Samples from Leeds are tested at a sentinel laboratory and are included here.

Positivity increased slightly from 0.3% to 0.4%. Positivity among ED-referred tests was lower than both the overall positivity rate and that observed in drug service, consistent with testing being undertaken in populations at lower risk of HCV infection.

Figure 10. Percentage positivity for anti-HCV tests by setting or reason for test in sentinel laboratories 2020 to 2024

Data source: SSBBV. For more information, see Information on data sources.

Numbers next to bars indicate the number of positive cases in 2020 to 2024.

Note 19: percentage positive is calculated using the number of individuals tested per year per speciality. If an individual has multiple tests in a year across multiple specialities then they will be counted once per speciality.

Between 2020 and 2024, community outreach had the highest anti-HCV positivity, at 28.1%, followed by drug services at 20.4%. Drug services identified the largest number of positive individuals, with 4,520 positives from 22,139 people tested. Prison services identified 183 positive individuals with a positivity rate of 6.1%. Positivity was around 1% in sexual health services (15,432 tests) and paediatrics (2,600 tests), Less than 1% of tests from hospital departments, GPs, occupational health and FMTC (fertility/mother-to-child) were positive, although these settings collectively reached large numbers of people (171,286).

Figure 11. Percentage of individuals testing anti-HCV positive among those tested in sentinel laboratories, by operational delivery network (ODN), 2020 to 2024

Data source: SSBBV. For more information, see Information on data sources.

Numbers next to bars indicate the number of positive cases.

Note 20: ODN boundaries do not fully align with UKHSA regional boundaries, so not all Yorkshire and Humber residents may be captured within the highlighted bars. Bars are highlighted in the above chart based on the region containing the majority of their residents. Consequently, the highlighted bars may include cases from outside the region, and some residents of this region may fall into ODNs / highlighted bars associated with other regions.

Both testing volume and anti-HCV positivity varied greatly across operational delivery network (ODNs) during 2020 to 2024. South Yorkshire had the highest positivity of all ODNs at 30.2%. Positivity in Humberside and North Yorkshire and West Yorkshire was substantially lower at 4.7% and 2.1%, respectively. However, unlike Humberside and North Yorkshire and West Yorkshire, South Yorkshire does contain a sentinel laboratory and only 5,672 individual tests contribute to these results compared to 33,047 and 173,186 individuals in Humberside and North Yorkshire and West Yorkshire, respectively. Further, testing for all drug services in England is conducted by a sentinel laboratory. Therefore, the majority of these tests conducted in South Yorkshire ODN are from drug services which is contributing the high positivity rates. Given differences in sentinel laboratory coverage, testing activity and referral sources, this graph should not be used as a direct comparison between ODNs.

Figure 12. Percentage of individuals tested positive for HCV RNA in sentinel laboratories in Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: SSBBV. For more information, see Information on data sources.

The proportion of people testing positive for HCV RNA in sentinel laboratory surveillance declined steadily from 54.4% in 2015 to 18.2% in 2024, a reduction of more than two-thirds over the 10-year period. Positivity fell by a further 7.5 percentage points between 2023 (25.7%) and 2024. During this period, the number of people tested increased from 3,942 in 2015 to 5,094 in 2024, with the highest number reported in 2023 (6,010).

Figure 13. Percentage of individuals testing HCV RNA positive among those tested in sentinel laboratories, by operational delivery network (ODN), 2020 to 2024

Data source: SSBBV. For more information, see Information on data sources.

Numbers next to bars indicate the number of positive cases.

See note 20.

Both testing volume and HCV RNA positivity varied across ODNs during 2020 to 2024. Among Yorkshire and Humber ODNs, HCV RNA positivity was highest in Humberside and North Yorkshire at 32.6%, followed by South Yorkshire at 29.6% and West Yorkshire at 24.7%.

West Yorkshire tested the greatest number of people (15,484) and identified 3,830 positive individuals, while Humberside and North Yorkshire identified 2,591 positive individuals from 7,942 individuals tested and South Yorkshire identified 870 positive individuals from 2,938 individuals tested.

Testing and diagnosis in people who inject drugs (PWID)

Figure 14. Percentage of Unlinked Anonymous Monitoring (UAM) Survey participants with evidence of ever being infected with HCV (anti-HCV), Yorkshire and Humber UKHSA region and England, 2015 to 2024

Data sources: UAM Survey. For more information, see Information on data sources.

Note 21: 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 considered when interpreting data for these years. Due to small numbers, data for 2020 and 2021 is combined. See Technical Notes for more details.

In 2024, 54.5% of UAM Survey participants in Yorkshire and Humber had evidence of ever having been infected with HCV, compared with 51.9% across England. This proportion has remained relatively stable in the region over the past decade. This measure represents cumulative exposure and remains positive after successful treatment, so it does not indicate current infection. Regional annual estimates can fluctuate because the survey recruits through participating services.

Figure 15. Percentage of Unlinked Anonymous Monitoring (UAM) Survey participants ever infected with HCV who have chronic HCV infection, Yorkshire and Humber UKHSA region and England, 2015 to 2024

Data sources: UAM Survey. For more information, see Information on data sources.

Note 22: 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 considered when interpreting data for these years. Due to small numbers, data for 2020 and 2021 is combined. See Technical Notes for more details.

The percentage of UAM Survey participants with chronic HCV infection in Yorkshire and Humber fell to 7.8% in 2024, below the England estimate of 9.9%. This was a substantial reduction from 55.9% in 2015. The reduction is consistent with the impact of expanded testing and direct-acting antiviral treatment among people who inject drugs.

Figure 16. Percentage of Unlinked Anonymous Monitoring (UAM) Survey participants who self-reported being recently (current or previous year) tested for HCV, Yorkshire and Humber UKHSA region and England, 2015 to 2024

Data sources: UAM Survey. For more information, see Information on data sources.

Note 23: 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 considered when interpreting data for these years. Due to small numbers, data for 2020 and 2021 is combined. See Technical Notes for more details.

In 2024, 64.0% of UAM Survey participants in Yorkshire and Humber reported having an HCV test in the current or previous year. This was higher than the England estimate of 52.6% and the highest proportion for the region over the last 10 years, increasing by 11.7 percentage points from 2023.

Hepatitis C treatment pathway

Figure 17. Treatment pathway in Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: SSBBV, NHS England (NHSE) Hepatitis C Patient Registry and Treatment Outcome System, NHSE Blueteq System. For more information, see Information on data sources.

Note 24: 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 25: 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.

Definitions of the numerator and denominator for each metric shown in the treatment pathway are provided in Table 3 of the Technical Notes.

Between 2015 and 2024, 88.1% of individuals with chronic hepatitis C were linked to treatment, of whom 96.6% initiated treatment. Overall, 85.2% of individuals with chronic hepatitis C started treatment, exceeding the WHO elimination target for treatment coverage (≥80%). Among those who started treatment, 94.0% had a recorded outcome and 95.0% of these achieved sustained virological response (SVR), equivalent to 88.4% of those who started treatment.

Treatment pathway by operational delivery network (ODN)

1) Humberside And North Yorkshire ODN

Figure 18. Treatment pathway by operational delivery network (ODN) in Humberside and North Yorkshire ODN, 2015 to 2024

Data source: SSBBV, NHS England (NHSE) Hepatitis C Patient Registry and Treatment Outcome System, NHSE Blueteq System. For further information, see Information on data sources.

See notes 24 and 25.

Note 26: ODN boundaries do not fully align with UKHSA regional boundaries, so not all Yorkshire and Humber residents may be captured in this chart. ODN charts are presented within this report for the region containing the majority of their residents. Consequently, these charts may include cases from outside the region, and some residents of this region may be in ODNs falling in other regions and so be included in other regions’ reports.

Between 2015 and 2024, 89.2% of individuals with chronic hepatitis C in the Humberside and North Yorkshire ODN were linked to treatment, of whom 97.2% initiated treatment. Overall, 86.7% of individuals with chronic hepatitis C started treatment, exceeding the WHO elimination target for treatment coverage (≥80%). Among those who started treatment, 96.2% had a recorded outcome and 90.7% of these achieved SVR, equivalent to 87.2% of those who started treatment.

2) South Yorkshire ODN

Figure 19. Treatment pathway by operational delivery network (ODN) in South Yorkshire ODN, 2015 to 2024

Data source: SSBBV, NHS England (NHSE) Hepatitis C Patient Registry and Treatment Outcome System, NHSE Blueteq System. For further information, see Information on data sources.

See notes 24, 25 and 26.

Between 2015 and 2024, 84.9% of individuals with chronic hepatitis C in the South Yorkshire ODN were linked to treatment, of whom 95.2% initiated treatment. Overall, 80.9% of individuals with chronic hepatitis C started treatment, exceeding the WHO elimination target for treatment coverage (≥80%). Among those who started treatment, 94.7% had a recorded outcome and 92.6% of these achieved SVR, equivalent to 87.7% of those who started treatment.

3) West Yorkshire ODN

Figure 20. Treatment pathway by operational delivery network (ODN) in West Yorkshire ODN, 2015 to 2024

Data source: SSBBV, NHS England (NHSE) Hepatitis C Patient Registry and Treatment Outcome System, NHSE Blueteq System. For further information, see Information on data sources.

See notes 24, 25 and 26.

Definitions of the numerator and denominator for each metric shown in the treatment pathway are provided in Table 3 of the Technical Notes.

Between 2015 and 2024, 88.3% of individuals with chronic hepatitis C in the West Yorkshire ODN were linked to treatment, of whom 96.5% initiated treatment. Overall, 85.2% of individuals with chronic hepatitis C started treatment, exceeding the WHO elimination target for treatment coverage (≥80%). Among those who started treatment, 92.6% had a recorded outcome and 96.4% of these achieved SVR, equivalent to 89.3% of those who started treatment.

Reinfections in individuals initiating treatment

For people who initiated treatment between 2015 and 2024 in Yorkshire and Humber, the reinfection rate was 5.6 per 100 person-years (95% confidence interval (CI) 5.2 to 6.0), which was lower than the England estimate (6.5 per 100 person-years, 95% CI 6.3 to 6.7). Among those who had injected drugs within the three years prior to treatment initiation, the reinfection rate was 6.7 per 100 person-years (95% CI 6.1 to 7.2), again lower than the England estimate. For individuals whose last injection was more than three years earlier, the rate was 4.6 per 100 person-years (95% CI 3.9 to 5.3), which was slightly higher than the England estimate. Among people with any history of imprisonment before starting treatment, the reinfection rate was 6.7 per 100 person-years (95% CI 6.0 to 7.5), which was lower than the England estimate.

Monitoring HCV-related morbidity

Hospital admissions from HCV

Figure 21. Number of first hospital admissions for hepatitis C-related end-stage liver disease (ESLD) and/or hepatocellular carcinoma (HCC), Yorkshire and Humber UKHSA region and England

Data source: Hospital Episode Statistics (HES), NHS England. Produced by the UK Health Security Agency. Copyright © 2025, reused with the permission of NHS England. All rights reserved. For more information, see Information on data sources.

Note 27: estimates of incidence of hepatitis C-related ESLD and/or HCC are not available for 2017 and 2018. This is due to an interruption in the supply of identifiers by NHS Trusts in tax year April 2017 to March 2018.

Note 28: data for 2024 is provisional and figures for previous years are subject to change as a result of late reporting and the associated de-duplication procedure.

Note 29: defined by codes or text entries for ascites, bleeding oesophageal varices, hepato-renal syndrome, hepatic encephalopathy, or hepatic failure.

Note 30: data based on HES as of December 2025.

The 2024 range estimates for first hospital admissions for HCV-related end-stage liver disease (ESLD) and/or hepatocellular carcinoma (HCC) in Yorkshire and Humber were broadly similar to levels seen in previous years. The lower estimate of first hospital admissions for HCV-related ESLD and/or HCC was 96 in 2024, unchanged from 2023, while the upper estimate increased from 117 to 131. Both estimates were below the regional peaks observed over 10 years ago, including 157 to 174 admissions in 2013. 

Nationally, the estimates continued to decline in 2024 to a lower estimate of 1,165 and upper estimate of 1,409 admissions.

Figure 22. Rate per 100,000 of first hospital admissions for hepatitis C-related end-stage liver disease (ESLD) and/or hepatocellular carcinoma (HCC), Yorkshire and Humber UKHSA region and England

Data source: Hospital Episode Statistics (HES), NHS England. Produced by the UK Health Security Agency. Copyright © 2025, reused with the permission of NHS England. All rights reserved. For more information, see Information on data sources.

Note 31: estimates of incidence of hepatitis C-related ESLD and/or HCC are not available for 2017 and 2018. This is due to an interruption in the supply of identifiers by NHS Trusts in tax year April 2017 to March 2018.

Note 32: data for 2024 is provisional and figures for previous years are subject to change as a result of late reporting and the associated de-duplication procedure.

Note 33: defined by codes or text entries for ascites, bleeding oesophageal varices, hepato-renal syndrome, hepatic encephalopathy, or hepatic failure.

Note 34: data based on HES as of December 2025.

The 2024 range estimates for rate per 100,000 population of first hospital admissions for HCV-related ESLD and/or HCC in Yorkshire and Humber were broadly similar to levels seen in previous years. The lower estimate of first hospital admissions remained at 1.7 per 100,000 while the upper estimate increased from 2.1 to 2.3 per 100,000.

HCV-related mortality

Figure 23. Number of deaths from hepatitis C-related end-stage liver disease (ESLD) and/or hepatocellular carcinoma (HCC), Yorkshire and Humber UKHSA region, 2005 to 2024

Data source: ONS Mortality and ONS MYE. For more information, see Information on data sources.

There were 24 registered deaths in the lower estimate for HCV-related ESLD and/or HCC in Yorkshire and Humber in 2024 (upper estimate 56), a slight increase from 20 in 2023 (upper estimate 48).

Figure 24. Mortality rate per 100,000 population for hepatitis C-related end-stage liver disease (ESLD) and/or hepatocellular carcinoma (HCC) by UKHSA region, 2020 to 2024

Data source: ONS Mortality and ONS MYE. For more information, see Information on data sources.

Across 2020 to 2024, the HCV-related ESLD and/or HCC mortality rate in Yorkshire and Humber was 1.2 per 100,000 population (CI 1.1 to 1.2). This was the joint third-highest regional rate with the South East, after London and the North West at 1.9 per 100,000. Regional differences may reflect historic HCV prevalence, population risk profiles and ascertainment, and should be considered alongside the uncertainty in attributing deaths to HCV.

Prevention of infection by harm reduction

Figure 25. Reported level of direct sharing of needles/syringes among people who inject drugs (PWID), in the preceding 4 weeks, Yorkshire and Humber UKHSA region and England, 2015 to 2024

Data sources: UAM Survey. For more information, see Information on data sources.

Note 35: 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 considered when interpreting data for these years. Due to small numbers, data for 2020 and 2021 is combined.

In 2024, 21.1% of UAM Survey participants in Yorkshire and Humber reported direct sharing of needles or syringes in the preceding 4 weeks. This was lower than the England estimate of 24.8% and below the regional peak of 28.7% in 2023, but higher than most years before 2022.

Figure 26. Reported level of direct and indirect sharing of injecting equipment among people who inject drugs (PWID), in the preceding 4 weeks, Yorkshire and Humber UKHSA region and England, 2015 to 2024

Data sources: UAM Survey. For more information, see Information on data sources.

Note 36: 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 considered when interpreting data for these years. Due to small numbers, data for 2020 and 2021 is combined.

In 2024, 37.5% of UAM Survey participants in Yorkshire and Humber reported direct or indirect sharing of injecting equipment in the preceding 4 weeks. This was below the England estimate of 44.4% and similar to 2023 (37.2%).

Information on data sources

Second Generation Surveillance System (SGSS)

Brief description

SGSS captures routine laboratory surveillance data on infectious diseases and antimicrobial resistance from laboratories within England. Along with a number of other organisms, hepatitis C is notifiable under the Health Protection (Notifications) Regulations (2010).

Technical notes

Laboratory reports of new diagnoses of HCV include positive test results for anti-HCV and HCV-RNA tests and are submitted to UKHSA or predecessor organisations via SGSS/CoSurv.

Data is assigned to local authority and UKHSA region by patient postcode where present, if patient postcode is unknown, data is assigned to local authority and UKHSA region of registered general practice; where both patient postcode and registered general practice are unknown data is assigned to local authority and UKHSA region of laboratory.

Dates are assigned based on earliest positive specimen date. Patient identifiable data submitted by NHS laboratories is variable, particularly from sexual health and drug and alcohol services, which limits the ability to deduplicate.

Laboratory reports for children under 1 year of age are excluded from the analyses to rule out detecting maternal antibody. Rates per 100,000 have been calculated using mid-year population estimates (MYE) supplied by the Office for National Statistics (ONS).

Caveat: SGSS data in this report may differ from data shown in the Hepatitis C in England report and from data reported in other surveillance outputs at a different point in time. This is due to the SGSS dataset being a live system and a number of cleaning, deduplication, remapping and other operational processes being routinely applied to the data to improve data quality.

Data extracted from Sentinel Surveillance of bloodborne virus testing (SSBBV) and SGSS will vary for several reasons and should not be compared: the 2 systems have collected data over different historical periods, with data reported to SGSS and predecessor systems since 1995, whereas SSBBV has been running since 2002. Data reported to SSBBV reflects the timeframe from when the laboratory joined the surveillance system, with laboratories joining more recently having less data available than laboratories who have been reporting since 2002. Furthermore, whilst SGSS collects national level data, SSBBV collects data from a subset of laboratories. Currently, 35 laboratories report to SSBBV with an estimated 45% coverage testing in the GP registered population in England.

Finally, it is not possible to differentiate a previous or current infection in SGSS with limited HCV RNA or HCV Ag data available, therefore numbers presented will be a mixture of previous and current infections. However, SSBBV allows for the collection of all HCV markers enabling HCV antibody and HCV RNA or HCV Ag to be presented separately.

Sentinel Surveillance of Bloodborne Viruses (SSBBV)

Brief description

SSBBV is a sub-national surveillance system for BBV testing activity and results in England, managed by UKHSA. Established in 2002, it includes data on all positive and negative BBV tests processed by the sentinel laboratories that participate in SSBBV. Laboratory participation in SSBBV is voluntary, and currently represents approximately 45% of the GP registered population in England. SSBBV includes the 2 laboratories that process DBS tests for the major drug services in England. Therefore, it is likely that the data covers most tests coming from drug services, where DBS is the main method of testing.

Technical notes

Patient identifiable data submitted by laboratories is variable, particularly from sexual health and drug and alcohol services, which limits the ability to de-duplicate. Data is de-duplicated subject to availability of date of birth, Soundex, NHS number and first initial. The proportion positive is calculated using the number of people tested.

For trends in hepatitis C antibody testing, SSBBV data is from 35 laboratories and is based on complete and consistent reporting since 2015 to remove any artificial increases or decreases in testing due to changes in reporting. This
means that the numbers of laboratories included for trend data may change each year depending on their reporting history. A positive test result first reported by participating laboratories may not reflect an individual’s first diagnosis.

Antibody testing excludes samples collected outside routine testing such as look back studies, reference testing, and children aged one year and under, whereas RNA or core antigen testing includes reference testing.

Reinfection

In England, 2 criteria have been used to identify hepatitis C virus reinfection, either of which would establish a person as experiencing reinfection:

• individuals with a positive hepatitis C virus RNA test at least 196 days (28 weeks) after treatment start date among those with a SVR during their first treatment period
• individuals who have a subsequent period of treatment after an initial SVR, and where this subsequent treatment period was at least 196 days after first treatment start date

For both definitions SVR is defined as either a recorded SVR or proxy SVR from a negative RNA or core antigen result after treatment. A period of 196 days between first treatment and reinfection diagnosis is used to define reinfection as the majority of individuals receiving treatment will have cleared hepatitis C virus within 6 months (182 days). A further 2 weeks (14 days) is added to account for any delays in treatment initiations. Reinfection after spontaneous clearance is not included.

The estimate now includes multiple reinfections, whereby someone is treated after experiencing their first reinfection and achieves an SVR but then has a subsequent hepatitis C virus RNA or core antigen positive result. The data is reliant upon persons initiating treatment being added to the NHSE Blueteq System or NHSE Hepatitis C Patient Registry and Treatment Outcome System, sufficient identifiers being available to link between the treatment and SSBBV databases and on people being tested post treatment. It should be noted that there is no internationally agreed definition for defining hepatitis C reinfection and a different window period may be used to confirm SVR post treatment. For example, Scotland uses a negative test between 10 weeks and 12 months post treatment to confirm SVR. As we progress towards elimination of hepatitis C virus as a public health threat, ongoing work across the UK will aim to harmonise definitions of reinfection where possible and utilise multiple methods, including the use of whole genome sequencing, to better understand reinfection.

Hospital Episode Statistics (HES)

Brief description

New cases of hepatitis C-related ESLD and/or HCC are monitored using HES for incidence of ESLD and HCC, and HES and SGSS for hepatitis C diagnoses. This is a new method in 2025 which presents data as a sensitivity analysis with upper and lower bounds, mirroring the updated methodology for deaths from hepatitis C-related ESLD and/or HCC. New cases are identified by first linking all episodes of ESLD and/or HCC in HES for an individual using their unique patient identifier. These are classified as ‘new’ if no previous episodes of ESLD and/or HCC for that individual are found in at least the previous 5 years (less than 1% of HCC and/or ESLD episodes are estimated to have had a previous episode more than 5 years earlier).

Linkage to hepatitis C diagnoses uses the following 2 methods:

1. Lower bound: linkage to episode of hepatitis C in HES for all years: first diagnosis of ESLD and/or HCC linked to hepatitis C diagnosis in HES for any year. First diagnosis of ESLD and/or HCC used data from 2003 to 2024 to give minimum 5-year window for first episode starting at 2010. Hepatitis C diagnosis started from 1 April 2000 onwards. Hepatitis C includes both acute and chronic cases.
2. Upper bound: linkage to diagnoses of hepatitis C in HES or surveillance data for all years: first diagnosis of ESLD and/or HCC linked to earliest diagnosis of hepatitis C in any of HES or SGSS.

Due to the loss of identifiers in HES data for 2017, data for 2017 and 2018 is omitted. More information is available in the Appendix 3 of Hepatitis C in England 2022.

Hepatitis C Treatment Pathway data

Brief description

Hepatitis C treatment initiation data is used to monitor access to hepatitis C treatment. Treatment coverage is defined as the proportion of individuals diagnosed with chronic hepatitis C (hepatitis C virus RNA or hepatitis C core antigen test positive) and who initiated treatment during a specified time frame over the number of individuals diagnosed with chronic hepatitis C for the specified time period.

Technical notes

Records from individuals with a diagnosis of chronic hepatitis C reported through SSBBV (positive hepatitis C virus RNA or antigen tests) are linked to the NHSE Hepatitis C Patient Registry and Treatment Outcome System using NHS number, name, DOB, hospital number and NHSE’s Blueteq System using NHS number, DOB, Blueteq number and excludes children aged under one year.

Patient identifiable data submitted by SSBBV laboratories is variable, particularly from sexual health and drug and alcohol services, which limits the ability to link data sets or de-duplicate. Data is de-duplicated subject to availability of DOB, Soundex, NHS number and first initial. Data quality is assessed on an ongoing basis to verify the number of people who tested positive for hepatitis C virus RNA or core antigen. As individuals are followed through the care pathway, the denominator is updated to exclude people who have died or who have evidence of spontaneous clearance.

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 hepatitis C virus 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 hepatitis C virus infection or individuals who have cleared their hepatitis C virus 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.

The NHSE Hepatitis C Patient Registry and Treatment Outcome System was commissioned by NHSE in 2017 from the Arden and Greater East Midlands Commissioning Support Unit to capture more detailed information for patients. The hepatitis C virus treatment monitoring in England report summarises the data held within the registry and Treatment Outcome System up to the end of April 2018.

Table 3. Definitions of the numerator and denominator for metrics reported in the hepatitis C treatment pathway

Metric	Numerator	Denominator
Proportion of individuals diagnosed with chronic hepatitis C who were linked to specialist treatment services	Number of individuals linked to specialist hepatitis C treatment services via ODNs (identified through successful linkage to the NHSE Hepatitis C Patient Registry and Treatment Outcome System and/or NHSE’s Blueteq System).	Number of individuals who tested positive for hepatitis C virus RNA or core antigen with NHS number or name and date of birth (DOB) reported through SSBBV who had not died before linkage to treatment and where there was no evidence of possible spontaneous clearance.
Proportion of individuals linked to specialist treatment services who initiated treatment	Number starting treatment.	Number of individuals linked to specialist hepatitis C treatment services via ODNs.
Proportion of individuals diagnosed with chronic hepatitis C who initiated treatment (WHO target)	Number starting treatment.	Number of individuals who tested positive for hepatitis C virus RNA or core antigen with NHS number or name and DOB reported through SSBBV who had not died before linkage to treatment and where there was no evidence of possible spontaneous clearance.
Proportion of individuals who initiated treatment who had an outcome reported or had an RNA or core antigen test reported through SSBBV	Number of individuals who had a treatment outcome reported via the NHSE 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.	Number of individuals who started treatment.
Proportion of individuals who initiated treatment and were reported to have achieved SVR either as a treatment outcome or had an RNA or core antigen negative result reported through SSBBV	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.	Number starting treatment.
Proportion of individuals who initiated treatment and had an outcome reported or an RNA or core antigen test reported through SSBBV who were reported to have achieved SVR or had an RNA or core antigen negative test result	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.	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.

Office for National Statistics (ONS) Mortality data

Brief description

The number of hepatitis C virus-related deaths are used to measure mortality. Deaths are based on the year of death. International classification of diseases (ICD) tenth revision (ICD-10) codes for ESLD and HCC are used to identify deaths with ESLD or HCC as a cause or associated with hospital admissions for these conditions. The number of deaths was estimated using slightly different ICD-10 codes from those used by WHO. A comparison of the codes used can be found in the Hepatitis C in England 2022 report.

Technical notes

An updated method for estimating deaths from hepatitis C-related ESLD and/or HCC has been used for this report. The previous method of reporting that solely used death data from the Office for National Statistics (ONS) was shown to underestimate mortality rates from hepatitis C-related liver disease by up to 60%. To address this, an updated method is used that presents the estimated mortality attributable to hepatitis C as a range. The lower bound of this range is similar to the previous methodology using only ONS death registration data, while the upper bound uses ONS death registration data linked to data on hospital episode statistics (HES) data on viral hepatitis, ESLD and/or HCC and laboratory data on viral hepatitis diagnoses. The updated methodology has been applied to all previous years, and includes deaths by year of death rather than by year the death was registered as was previously used.

Lower bound represents deaths where ESLD and/or HCC and hepatitis C were reported in ONS death registration data (as year of death is now used this is not comparable with previously published estimates which used year the death was registered). Upper bound represents deaths where ESLD and/or HCC were reported in ONS death registrations or identified in HES hospital admissions data linked to deaths data, and hepatitis C diagnoses were identified by linking between ONS deaths, HES hospital admissions data and laboratory diagnosis data to yield a maximum number of deaths attributable to hepatitis C-related ESLD and/or HCC. Excluding deaths of people aged under 16 and deaths registered in England where the deceased’s usual residence is outside England. ESLD is defined by codes or text entries for ascites, bleeding oesophageal varices, hepato-renal syndrome, hepatic encephalopathy, or hepatic failure.

Unlinked Anonymous Monitoring (UAM)

Brief description

The voluntary UAM survey recruits people who have ever injected psychoactive drugs through specialist services (such as needle and syringe programmes and addiction treatment centres) across England, Wales and Northern Ireland. Those who agree to take part self-complete a questionnaire and provide a biological specimen that is tested anonymously for HIV, hepatitis B and hepatitis C.

Technical notes

Regional level data from the UAM survey should be interpreted cautiously as the survey recruits participants through a nationally reflective sample of the services provided to people who inject drugs.

The COVID-19 pandemic, and associated changes in service delivery, impacted on recruitment to the survey in 2020 and 2021. By 2022, the number of services taking part in the survey, and the number of participants was comparable to pre-pandemic levels.

Published regional-level data and more information can be found at People who inject drugs: HIV and viral hepatitis monitoring.

Acknowledgements

We would like to thank the following:

• local laboratories for supplying the hepatitis data
• the UKHSA Blood Safety, Hepatitis, STI and HIV Division for collection, analysis and distribution of data
• the UKHSA Epidemiology Data Science unit (part of the Epidemiology Data Science team) for producing the charts and figures contained in this report
• the Office for National Statistics (ONS), which carried out the original collection and collation of the mid-year population estimates, death registration data and geographic boundary data but bears no responsibility for their future analysis or interpretation)
• the Hospital Episode Statistics (HES), NHS England, produced by UKHSA

About Field Services

Field Services is a Division within UKHSA that provides a national service comprising geographically dispersed multi-disciplinary teams integrating expertise in Field Epidemiology, Public Health Microbiology, Rapid Investigation, Real-time Syndromic Surveillance, Field Epidemiology Training, and Data Science to strengthen the surveillance, epidemiological intelligence and response functions of UKHSA.

You can contact your local Field Services team at YHREU@ukhsa.gov.uk

 If you have any comments or feedback regarding this report or the Field Services, please contact FS.Central@ukhsa.gov.uk