• The hepatitis C virus was first identified in 1989
• Transmitted through exposure to blood from an infected person ▪ Most newly diagnosed cases of hepatitis C, in countries like Ireland, are in people who use drugs (PWUD) and migrants from higher endemicity countries
• Hepatitis C can also be transmitted from an infected mother to her baby and sexually - These modes of transmission are less common - The risk of sexual transmission is higher in gbMSM, in people living with HIV and those with genital sores/ulcers from sexually transmitted infections
• Most cases are initially asymptomatic or mildly symptomatic - acute infection is rarely detected & there can be a long lag time between infection and diagnosis.
• Approximately 70-75% of those infected develop chronic infection ▪ Chronic infection can cause liver inflammation, fibrosis, cirrhosis, liver cancer (hepatocellular carcinoma (HCC)), liver failure and death
• Hepatitis C is curable: Free antiviral treatment is available in Ireland through the HSE with a >95% cure rate, ~8,000 people treated since 2012, leading to a significant decrease in the estimated prevalence of chronic infection (0.1%, 2021-2023).

P.8 Risk factor information was reported for 84% of cases who were born in Ireland, with 76% reported to be people who inject drugs and 3% people who use drugs, but do not inject. Risk factor data were reported for less than half of cases born outside Ireland, with 34% of cases attributed to drug use. Sexual and healthcare-associated exposures were more commonly reported compared to cases born in Ireland. [Non injecting drug use, <1%, p.16]

P.18 Most likely risk factor for hepatitis C notifications in Ireland, 2024 (where data available - 44%, n = 203) - Most likely risk factor was reported for 44% of hepatitis C cases notified in 2024 and the distribution of risk factors is not likely to be representative of all cases. Where information was reported, 64% of cases were in people who inject drugs and an additional 2% in people who use drugs but do not inject.

P.24 Hepatitis C in prison settings – opportunity for micro elimination - It was recognised that incarceration provides an opportunity to address the healthcare needs of people who often belong to medically underserved communities e.g. PWUD and people who are homeless.

P.27 HSE Social inclusion Addiction services:

• Information on where to access addiction support, including free testing for hepatitis B, hepatitis C and HIV and vaccination against hepatitis A and B
• Health Research Board (HRB) Interactive national map of drug and alcohol services (launched in 2024)
• https://drugs.ie/ provides information about drugs, advice on harm reduction and information on addiction treatment
• Ireland’s first Medically Supervised Injection Facility (MSIF) opened in 2024, aiming to reduce drug injector deaths, bloodborne virus transmission, drug related litter and public injecting

Migrant health: 

• Safetynet Primary Care provides medical services, including infectious disease testing,to those without access to healthcare, including homeless people, people who use drugs (PWUD) and migrants