The Royal College of Pathologists has responded to the UK National Screening Committee (NSC) consultation on antenatal screening for hepatitis C virus (HCV), supporting its inclusion in the UK national antenatal screening programme. The response highlights significant developments in policy, evidence and practice since the last review in 2018.   

HCV remains a significant bloodborne infection with long-term consequences such as cirrhosis and liver cancer, and vertical transmission is the primary source of paediatric cases in high-income countries. In the context of HCV, a key purpose of screening is enabling identification and appropriate follow-up of exposed infants, given the high cure rates now achievable from early childhood. 

While the evidence map concludes that evidence is insufficient to justify further synthesis work at this time the College considers that: 

• The policy landscape has shifted materially, with multiple international bodies now recommending universal antenatal screening 
• The harms of undiagnosed maternal infection and missed infant follow-up are clear 
• The diagnostic pathway is robust and well established 
• Emerging real-world UK and international data demonstrate feasibility and acceptability 
• The UK is working toward WHO elimination targets for HCV by 2030 and antenatal screening provides a systematic opportunity to identify undiagnosed infection.  

The response supports universal screening implementation with a focus on identification of maternal infection to ensure infant follow-up pathways and linkage to postnatal treatment services.  

Read the full response below.