Hiqa recommends 1.5m people be tested for Hepatitis C

Everyone born in Ireland between 1965 and 1985 should be tested for the Hepatitis C virus (HCV), the Health Information and Quality Authority (Hiqa) has recommended.

The rate of Hepatitis C infection is highest among those born in the 20-year period, at about one case per 100 individuals, and the health watchdog has advised that the 1.5 million people in the cohort be checked for the blood-borne virus.

If left untreated, Hepatitis C can cause serious damage to organs and most people do not develop symptoms for decades.

From 2004 to 2018, a total of 15,266 HCV cases were notified to the Health Protection Surveillance Centre, with 71 per cent of these occurring in the 1965 to 1985 birth cohort. However, it is believed there are around 12,000 people with undiagnosed chronic HCV infection in the age group.

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This testing programme would cost an estimated €65 million over a five-year period, but Hiqa says it will be cost-effective. The recommendation has been submitted to the Minister for Health for his consideration.

Hiqa also said an initial pilot programme was needed to confirm the prevalence estimates and to address any feasibility issues.

‘Silent disease’

“Chronic HCV infection is frequently called the ‘silent disease’, as many people do not have symptoms and don’t realise that they are infected,” said Dr Máirín Ryan, Hiqa’s deputy chief executive and director of health technology assessment.

“However, the damage it does is not silent. If left untreated, chronic HCV infection can cause severe damage to the liver and other organs. For example, 128 liver transplants completed in Ireland between 2005 and 2018 were due to HCV.”

Dr Ryan said tests used to diagnose chronic HCV infection are highly accurate, and more than 95 percent of people who receive treatment are cured. Treatment involves an eight to 12 week course of antiviral oral tablets, which can be reimbursed through the HSE’s National Hepatitis C Treatment Programme.

However, treatment cannot reverse severe damage already caused to the liver, making early diagnosis of an infection vital.

The HSE aims to make Hepatitis C a rare disease before 2030, which is in line with the World Health Organisation’s target. Hiqa say the testing programme would help to achieve this goal.

The Department of Health was contacted for a comment on the Hiqa recommendation.