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Hepatitis

Volume 487: debated on Tuesday 10 February 2009

To ask the Secretary of State for Health in what proportion of patients with (a) chronic hepatitis, (b) cirrhosis and (c) hepatocellular carcinoma their condition is due to chronic infection with hepatitis B virus; and if he will make a statement. (254998)

It is not possible to use Hospital Episode Statistics to provide data on chronic hepatitis, cirrhosis or hepatocellular carcinoma due to hepatitis B virus. Although there are disease codes to describe these conditions individually, it is not possible to show that one condition has been caused by the other.

However, it is generally accepted that hepatitis B is a significant cause of chronic hepatitis, and that about 20 to 25 per cent. of individuals with chronic hepatitis B infection world-wide are at increased risk of developing cirrhosis and hepatocellular cancer.

To ask the Secretary of State for Health (1) if he will make additional funding available to primary care trusts for the use of pegylated interferon for the anti-viral treatment of chronic hepatitis B; and if he will make a statement; (254999)

(2) how much and what percentage of the 2008-09 budget of each (a) health authority and (b) primary care trust is allocated for the treatment of hepatitis B; and if he will make a statement.

Funding for hepatitis B treatment is included within the revenue allocations for primary care trusts (PCTs). The allocations also fund the costs of meeting recommendations from the National Institute for Health and Clinical Excellence. The 2008-09 PCT allocations represent £74.2 billion investment in the national health service, a total increase in funding of £3.8 billion. PCTs have also been informed of their 2009-10 and 2010-11 allocations, a total of £164 billion investment over the two years, a cash increase of £8.6 billion.

The Department does not break down PCT allocations by policies, at either a national or local level. It is for PCTs to decide their priorities for investment locally, taking into account both local priorities and the NHS Operating Framework.

Responsibility for providing services for the treatment of chronic hepatitis B lies with PCTs and their local partners, as they are best placed to assess what is needed in their areas. Information about local expenditure on hepatitis B services is not available centrally.

To ask the Secretary of State for Health (1) what studies have been (a) commissioned and (b) evaluated by his Department into the likely incidence of chronic hepatitis B over the next (i) five and (ii) 10 years; and if he will make a statement; (255002)

(2) what studies have been (a) commissioned and (b) evaluated by his Department on monitoring the changes in the epidemiology of hepatitis B infection following the introduction of an anti-viral treatment with interferon and ribvarin since 1997; and if he will make a statement.

The Department has not commissioned or evaluated any studies into the incidence of chronic hepatitis B over the next five or 10 years in England or into the effect of antiviral therapy on the epidemiology of chronic hepatitis B since 1997.

Surveillance of hepatitis B suggests that the incidence of both chronic and acute hepatitis B in this country remains low. The Health Protection Agency monitors epidemiological trends in hepatitis B infection and published in 2004 a review of the incidence of hepatitis B in England and Wales from 1995-20001.

Ribavirin is used (in combination with pegylated interferon) for the treatment of chronic hepatitis C, not chronic hepatitis B, as recommended by the National Institute for Health and Clinical Excellence.

1 Hahne S, Ramsay M, Balogun K, Edmunds WJ and Mortimer P. (2004). Incidence and routes of transmission of hepatitis B virus in England and Wales, 1995-2000: implications for immunisation policy. Journal of Clinical Virology 29:211-20.