The World Hepatitis Alliance’s (WHA) global campaign for World Hepatitis Day 2018 on 28 July and the next three years focuses on ‘finding the mission millions’ with viral hepatitis. It is estimated that only 11% of people with viral hepatitis are aware, meaning 89% (around 290 million people) are unaware.

The campaign aims to tackle the main barriers to diagnosis: lack of public knowledge of the disease, lack of knowledge of the disease among healthcare professionals, lack of easily accessible testing, stigma and discrimination, and out of pocket cost to patients.

Hepatitis is an inflammatory condition that affects the liver. It is usually caused by a viral infection; however, it can also be caused by an autoimmune response or the result of medicines, toxins or alcohol.

One form of hepatitis, hepatitis C virus (HCV), can often have no symptoms. If left untreated HCV can cause liver scarring, which can lead to liver disease, failure and cancer.

In 2016, 194 World Health Organisation (WHO) member states, including the UK, signed the WHO Global Health Sector Strategy on Viral Hepatitis, which included a commitment to eliminate HCV by 2030. NHS England pledged it would aim to eliminate the virus by 2025 in January 2018.

Hepatitis C coalition chair Professor Steve Ryder wrote in the organisation’s report: "The government and NHS England’s commitment to tackling the disease is welcome and, thanks to new medicines, we have made significant steps in the right direction. In 2015, the NHS treated virtually every UK patient who developed cirrhosis as a result of HCV and has reversed the growing mortality.

"Hepatitis C could be the UK’s next big public health success story. But, if we want to eliminate it by 2025 we need a concerted and coordinated effort to find undiagnosed patients and treat them."

It has been estimated that 160,000 people in England and 214,000 in the UK are chronically affected by HCV and between 40% and 50% remain undiagnosed.

British Liver Trust chief executive Judi Rhys said: "A key challenge in ‘finding the missing millions’ will be the fact that hepatitis C often has no symptoms in the early stages and it is thought that less than half of those living with the virus have been diagnosed. It is therefore vital that anyone who is at risk asks to be tested.

"Many people who are undiagnosed are not aware that they may be at risk. We would urge anyone who has ever dabbled in drugs (even if it was many years ago); had unprotected sex with someone who may have been infected; had a tattoo or received healthcare in a country with a high prevalence of the virus or who may be have been put at risk in their workplace, for example from a needle stick injury, to get tested to be sure."

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