Hepatitis C can be transmitted to partners, and 5% of women with Hepatitis C will transmit it to their babies. Deaths from Hepatitis C are under-reported and sufferers fail to be referred for specialist treatment due to under-diagnosis. The NHS faces an epidemic of undiagnosed and untreated chronic Hepatitis C patients requiring extensive in-patient treatment as they emerge at the end-stage of the disease.
The benefits to patients and health-care costs of early diagnosis are clear. The French government is requiring that its healthcare system detect at least 80% of their cases by 2004, in the USA it is public policy that all of their citizens who have had a blood transfusion prior to the availability of donor testing attend their physician for a blood test. Lord Hunt, in debate (Lords Hansard, 1 Nov 2000 : Column 1031) acknowledged that, "in the future, the NHS will have the ability to prevent this distressing disease, as far as that is possible, and ensure that counselling and testing services are up to the required standard..... We are determined to do what we can to ensure that the services and the prevention of this most distressing disease are given as much priority as is possible"
Evidence grows that Hepatitis C is not just an issue related to habitual intravenous drug use, but also resides as a chronic infection throughout society. The means for diagnosis and treatment exist, including NICE guidance on therapy.
Adding a test for Hepatitis C to the routine antenatal blood screen would be an effective step towards dealing with the Hepatitis C issue, along with a public awareness of the role of transfusion in passing on the infection prior to the availability of routine donor testing.
Recognition that occasional recreational use of intravenous drugs up to twenty years ago will have led to a reservoir of chronic Hepatitis C infection in middle class, middle England will also remove the assumption that it is only a problem for chronic drug abusers and prison inmates.
The recent meeting in Madrid, of the European Association of the Study of the Liver, provided evidence that Hepatitis C is destined to become one of the major public health issues of the 21st century. There is little doubt that the UK government must soon act to avoid the suffering and expense resulting from an epidemic of citizens, with undiagnosed Hepatitis C, swamping hospital beds at the end stage of their condition.