Epidemiology and Infection

Original Papers

Hepatitis C

Estimating hepatitis C infection acquired in England, 1986–2000

M. A. BALOGUNa1 c1, A. J. VYSEa1, L. M. HESKETHa2, G. KAFATOSa3, J. V. PARRYa4a5 and M. E. RAMSAYa1

a1 Immunisation Department, Health Protection Agency, Centre for Infections, London, UK

a2 Lancashire Teaching Hospitals NHS Trust, Preston Microbiology Services, Royal Preston Hospital, Preston, Lancashire, UK

a3 Statistics, Modelling and Economics Department, Health Protection Agency, Centre for Infections, London, UK

a4 Virus Reference Department, Health Protection Agency, Centre for Infections, London, UK

a5 Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK


Hepatitis C is a global health problem and in the UK seroprevalence studies have mainly concentrated on specific high-risk groups. The aim of this study was to determine changes in the prevalence of antibody to hepatitis C virus in England using residual specimens collected between 1986 and 2000 reflecting the general population. A cross-sectional study design using a convenience collection of serum specimens from adult patients submitted to laboratories in the years 1986, 1991, 1996 and 2000 from a total of 19 laboratories around England were investigated. The main outcome was to determine anti-HCV prevalence and the average incidence occurring between 1986 and 2000 and factors associated with infection. Multivariable analysis of results from all years showed there was a significant difference in prevalence between males and females (P<0·001), birth cohort (P<0·001) and by health region (P<0·001). An average of 0·72% (95% CI 0–1·65%) of those susceptible to HCV born between 1950 and 1970 were estimated to have acquired the infection between 1986 and 2000. Analysis of this convenience serum collection suggests that HCV prevalence is low in the general population, and is associated with period of birth, gender and health region. There was evidence to support a low incidence of HCV infection in those born between 1950 and 1970 over the period 1986–2000 which, at the population level, equated to a substantial burden of infection (~106 000 persons). Continued surveillance and prevention targeted at injecting drug users are essential for the control of hepatitis C in the UK.

(Accepted January 16 2009)

(Online publication March 10 2009)


c1 Author for correspondence: Dr M. A. Balogun, Health Protection Agency, Centre for Infections, Immunisation Department, 61 Colindale Avenue, London NW9 5EQ, UK. (Email: koye.balogun@hpa.org.uk)