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HCV infection should be managed in specialist centres
  1. J L Brown
  1. Cranfield Postgraduate Medical School in Gloucestershire, Gloucester Royal Hospital, Gloucester GL1 3NN, UK; j.brown@rmcs.cranfield.ac.uk

https://doi.org/10.1136/gut.51.5.626

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    It has been estimated that between 200 000 and 400 000 people in England and Wales have hepatitis C virus (HCV) infection, with subgroup prevalences of 0.04% in healthy blood donors, 0.4% in antenatal clinic attendees (in London), 1% in genitourinary clinic attendees, and up to 50% in intravenous drug users.1 The population in England and Wales is close to 50 million,2 implying that approximately 0.5% are viraemic as 85% of acute infections lead to chronic disease.3 A district general hospital serving a population of 350 000 people may therefore have 1750 viraemic individuals in its catchment area. Although the fraction of this hypothetical iceberg that is visible to secondary care is currently small and varies according to local demographics, it is already of the order of 15% in rural Gloucestershire (personal data).

    Comprehensive consensus guidelines for the management of HCV infection have been published by both the NIH4 and EASL,5 and one of the major factors in delay of implementation in the UK has been lack of resources in terms of clinicians’ time, nursing supervision, counsellors, and the drug budget. Nevertheless, in order to help British clinicians meet the ever increasing demand for the management of HCV, the Royal College …

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