Hepatitis B and C among ethnic minorities

The UK NSC policy on Hepatitis B and Hepatitis C screening among ethnic minorities born outside the UK

More Information

Chronic infection with either hepatitis B virus (HBV) or hepatitis C virus (HCV) can cause serious liver disease, including cirrhosis and hepatocellular carcinoma (HCC) cancer, decades after infection. Illness due to chronic hepatitis, cirrhosis and HCC are more common among ethnic minority than among white groups in the UK, as would be expected given the higher rate of infection with HBV and HCV among these groups.

Mild or moderate HCV disease is associated with various conditions - fatigue, depression and neurocognitive deficits being among the most common. However, among individuals who are infected with HBV, but have not developed liver disease, health is usually not affected.

» Read more about hepatitis C in people from South Asian countries on NHS Choices

Policy Position

A national screening programme for hepatitis B and hepatitis C among ethnic minorities born outside the UK is not recommended.

This policy was reviewed in Apr 2011 but no significant changes were made. It is due to be considered again in 2014/15, or earlier if significant new evidence emerges.

Evidence Supporting the Policy

The screening review concluded that it is not yet clear whether there is an effective means of identifying and issuing invitations to all individuals in the target population.

Many authorities state that, without therapy, between 20-30% of patients with chronic hepatitis B virus infection will die of complications such as cirrhosis or hepatocellular carcinoma. However, the review did not find any evidence from which the long-term (> 10 years) natural history of chronic hepatitis B virus infection among non-western individuals can be reliably inferred. The true figure may be more or less than 20-30%.

The review stated that the cost-effectiveness of the proposed screening programme needs to be assessed, using assumptions that are up to date, realistic and relevant in the UK context.

Stakeholders

The Afiya Trust
Black Health Agency
British Association for Study of the Liver
British Infection Association
British Liver Nurses' Forum
The British Liver Trust
British Society for Immunology
British Society of Gastroenterology
British Viral Hepatitis Group
Chinese National Healthy Living Centre
Department of Health Advisory Group on Hepatitis
Health for Asylum Seekers and Refugees Portal
Health Protection Agency
Health Protection Scotland
Hepatitis B Foundation UK
Hepatitis C Trust
Muslim Health Network
Public Health Agency for Northern Ireland
Public Health Wales
Royal College of General Practitioners
Royal College of Pathologists
Royal College of Physicians
Royal College of Physicians of Edinburgh
South Asian Health Foundation

The stakeholder groups will be involved when the policy is next reviewed. If you think your organisation should be added, please contact us.

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