Background
Surveillance of hepatitis C (HCV) infection has been carried out by the Health Protection Agency (HPA; formerly the Public Health Laboratory Service Communicable Disease Surveillance Centre or CDSC) since 1990. Routine surveillance information is derived from reports of confirmed HCV infections from laboratories in England and Wales. However, because of the low proportion of acute HCV infections that are symptomatic, the long interval between acquisition of infection and chronic disease, and the lack of serological markers of acute infection, laboratory reporting alone cannot be used to determine current and past HCV incidence and may merely reflect current and previous laboratory testing patterns. In addition, as testing for HCV is often performed on asymptomatic individuals with a history of high risk exposure, laboratory reports give no indication of the level of morbidity from infection and cannot be used for estimating current or future burden of disease.
The Department of Health therefore commissioned CDSC in 2002 to undertake a sentinel surveillance study of hepatitis testing in order to supplement the data gathered through routine surveillance with information on trends in testing and risk exposures.
The study has grown from seven participating laboratories in 2002 to 23 active laboratories in January 2008 (from a total of 25 laboratories which have ever contributed data), at least one in each region of England. A list of currently active centres can be found under Participating centres.
A list of recent publications from the study, including quarterly updates on testing published in Health Protection Report, can be found under Further Information.
Data from the sentinel surveillance study have also been used in a number of other initiatives, including:
- an evaluation of the level of under-reporting in the routine national surveillance scheme for hepatitis C;
- an audit of hepatitis C virus testing in London and the South East;
- several assessments of trends in hepatitis testing in the wake of awareness campaigns, on behalf of the Department of Health;
- a new scheme to follow up recently-acquired hepatitis C infections in collaboration with local laboratories and Health Protection Units.