Genomic and phylo-epidemiological analysis of HCV diversity and antiviral resistance in the UK

Whilst the number of people with HCV in England has dropped, the rate of new infections among PWID has stabilised, increasing the potential for emergent resistant viral strains. As susceptible viral strains are eliminated with DAAs, resistant strains or those imported from other countries may become dominant. The use of WGS will help understand HCV transmission dynamics, providing the ability to distinguish between relapse and reinfection, and allowing estimation of rates of reinfection and mixed infections in key risk groups, thereby informing public health interventions. We estimated rates of HCV transmission and reinfections in PWID and MSM, PrEP users and those with HIV.

These data could support investment in focused interventions to reduce HCV transmissions, such as development of behavioural interventions around safer injecting and chemsex practices.