Up to 200,000 people will die from hepatitis C infection in Britain over the next 20 to 30 years unless diagnosis and treatment of the disease improves dramatically, doctors predicted yesterday. They warned that the government was underestimating the looming public health disaster, comparing its record in tackling the problems unfavourably with administrations in France, Germany, Italy and Spain.
Experts led by William Rosenberg, a consultant at Southampton general hospital, for a study commissioned by the Hepatitis C Trust, suggest that at least 500,000 people carry the virus, and that that "conservative" estimate is double the government figures. Nine in 10 people are unaware of their infection and the numbers will rise steadily unless public awareness campaigns encourage people who might be infected to offer themselves for screening via a blood test.
Over 30 years, about 30% of people infected will not develop liver disease, but 40% might suffer relatively minor damage to their liver, and 30% will face serious damage to their organs, many of whom will need transplants, for which there will be long waiting lists.
The cost to the NHS could rise over the same period to £8bn.
Professor Rosenberg accused the NHS of regarding hepatitis C as "a low-life disease" because many diagnosed are drug injectors. Yet others included those who only "dabbled" in drugs and decades ago. Hepatitis C can spread through blood on needles or other surfaces, and cocaine can cause localised bleeding in the nose.
"My clinic is packed full of lawyers and bankers. They are what we would call respectable, middle-class, people who dabbled when at university or in their teens. It might be a person who took a little bit of [injected] speed in the 60s. You could have been a very infrequent injector in the past. It could be you snorted cocaine in the 80s for a couple of years."
Other patients developed disease from infected blood products and transfusions. Heat treatment for products for people with haemophilia was only introduced in 1986 and a blood test to protect traditional blood transfusions came five years later.
People who come to Britain from abroad may have been infected through transfusions or medical equipment, and other less common infection routes include poor hygiene at tattoo parlours, shared toothbrushes and razors, mother to baby transmission, and, rarely, sex.
Only about one in 20 people who undergo blood tests which then indicate infection receive drugs that might cure them, say campaigners, and that figure represents only 1-2% of those who might be infected.
Courses, involving weekly intravenous treatments and twice daily tablets, can last six or 12 months depending on the strain of hepatitis C. But these drugs, costing £12,000 for the year, cure about 60% of those prescribed them.
Researchers say many people fall out of the system between first warnings through blood tests and the eventual treatment. Some hospitals never receive GP referrals, patients are often highly mobile and do not receive the results of tests, and some either do not believe how serious the virus can be, or worry that there is a stigma linked to the disease.
In France, 13% of people infected with the disease are treated, which is a level six to 12 times better than that occurring in Britain. Critics compare the £2.5m being spent on an awareness campaign in England with the £50m being spent in the battle against sexually transmittted diseases.
The Department of Health said the Health Protection Agency believed about 200,000 people in England might be infected, of whom just under one in five had been diagnosed through tests.
