NHS expands ‘one-hour’ liver testing to help detect and eliminate Hep C

Thousands of people unknowingly living with hepatitis C are to be identified, diagnosed and cured thanks to major NHS investment in rapid testing technology and an extension of a ground-breaking medicines deal.

New liver scanning and portable testing units will be deployed in a range of communities where patients are at high risk of contracting the infection. This includes on community clinical outreach vans, at drug and alcohol support services, or at special testing events in some GP practices as part of the final phase of the dedicated hepatitis C Elimination Programme, which could see England become to first country in the world to eliminate the virus as a public health threat.  

Once found by targeted outreach, hepatitis C patients can be treated on the NHS with antiviral medicines all thanks to a two-year extension to a pioneering deal with three pharmaceutical companies, to supply the latest antiviral drugs

Since the elimination programme drive began in 2015, around 84,000 people have been treated for hepatitis C and it is hoped the virus can be stamped out as a public health concern in England, years ahead of the World Health Organisation's 2030 ambition.

NHS national medical director, Professor Sir Stephen Powis, said: “This investment ensures the NHS will continue to save thousands of lives and set the international standard in the drive to eliminate hepatitis C by 2030 and, while tackling a significant health inequality.

“New portable testing devices, and an extension of our landmark commercial deal, is helping us reach those most at risk as we begin our final push to wipe out the virus and find and cure any remaining cases.

“We urge anyone who could be living with hepatitis C to get checked for peace of mind – there are a range of ways to get tested, including screening programmes or doing a simple test at home – if left untreated, the virus can lead to life-threatening conditions, but treatment is simple, curative and easily accessible.”  

Hepatitis C is a virus that affects the liver and, if left untreated, can cause serious and potentially life-threatening damage over many years. The virus is usually spread through blood-to-blood contact and those at particular risk, include people who use, or used, drugs, current or former prisoners, the homeless, or people born in a country where the bloodborne disease is endemic. 

It is estimated that over 60,000 people may be currently living with chronic hepatitis C in England without knowing they have the virus. This is because often there are no specific symptoms until the liver has been significantly damaged. When symptoms do occur, they can often be mistaken for other conditions.

Christine Webb from London was treated for hepatitis C in 2020 after receiving a call from her doctor suggesting she may have the infection based on her historic records.

A positive test result revealed Christine did have the virus and she was immediately referred for an emergency appointment.

Christine said: “A simple hepatitis C test can make all the difference. I took the tablet treatment, which is so easy to take and had great results. I finally have energy. I no longer have brain fog and can function properly in work and in life and make proper decisions.”

Christine, a keen gardener, received her treatment at Croydon University Hospital and St George's Hospital in London.  After being cleared of Hepatitis C, she signed up to volunteer with the Hepatitis C Trust and now works for the charity.

She said: “Awareness of hepatitis C is vital, even if you contract the infection again, you can still receive treatment.

“Without these medicines, hepatitis C can lead to liver failure and cancer, so it's really important that people are aware of the risks and get tested.”

NHS England is investing £4.2m to buy 25 FibroScan machines, which will be deployed in communities and care settings and facilities where there are potential hepatitis C patients. The scanners test for liver damage and provide immediate results, referring people to onward care if needed and helping to diagnose liver disease and liver cancer at an earlier, more treatable stage.

Thirty-four Cepheid GeneXpert portable testing units will also be procured and expanded to community settings including GP clinics and prisons, to allow the elimination programme's teams to test people experiencing homelessness or drug users who may struggle to meet appointments. The kit can detect whether people are infected with the hepatitis C virus in less than 60 minutes.

Complementing this, the two-year extension of the deal originally struck in 2019 will see the NHS continuing to work together with drug firms Gilead Sciences, Merck Sharp and Dohme (MSD) and AbbVie to ensure patients can access the latest antiviral treatments.

Dr Monica Desai, Head of Hepatitis at UKHSA, said: “Hepatitis C elimination as a public health threat is in reach if we can accelerate testing, support people to access effective treatment that clears the virus, reduce the stigma experienced by people living with hepatitis C and prevent people getting the infection in the first place - particularly for people who inject drugs.  

“The symptoms of hepatitis C can go unnoticed for years. But the sooner you are diagnosed, the quicker you can get access to curative treatments and prevent serious liver damage. So, if you have ever injected drugs, even if it was a long time ago, please get tested. The test is quick and free and can be ordered via an online portal if you would prefer that rather than visiting your GP. You should also get tested if you have ever had medical treatment abroad, or had condomless sex with someone who may have hepatitis C.”

Ben Lucas, Managing Director UK & Ireland, MSD, said: “The 2-year extension of NHS England's Hepatitis C Elimination Programme stands as evidence of the success achieved between NHS England, third sector partners, and the pharmaceutical industry.

“We celebrate elimination initiatives supported by MSD's Hep C Elimination Programme team, which has helped drive a positive impact across public health, including reducing health inequalities. As we enter the final stage of the programme, at MSD we look forward to continuing on our mission to save and improve lives, carrying forward our commitment to deliver initiatives that will have a lasting impact to eliminate Hepatitis C in England.”

Todd Manning, General Manager, AbbVie UK, said: “Our ongoing contribution to the UK's hepatitis C elimination programme is something we are incredibly proud of at AbbVie. 

“Since curative treatments became available in 2015, we have worked with the hepatitis C community and the NHS towards the goal of enabling all those living with this life-threatening disease to be cured.

“A lot has been achieved during this time and with some way still to go, it is vital that this and future Governments remain committed to a strategic approach, with sustained funding for services, which is just as critical as the procurement of medicines.”  

Julian Cole, Country Medical Director, Gilead UK & Ireland, said: “We are very proud to be extending our commitment to this innovative partnership, which has already achieved considerable success. Through close collaboration with our partners in addiction services and prison healthcare, alongside the NHS and The Hepatitis C Trust, we are advancing health equity and ensuring that everyone, regardless of their background or situation, can receive the treatment they deserve.

“The extension of this initiative with NHS England is a critical part of our leadership in liver disease and demonstrates our commitment to working collaboratively to achieve elimination of viral hepatitis by 2030.”

Rachel Halford, CEO of The Hepatitis C Trust, said: “Since the Hepatitis C Trust was founded over 20 years ago, the progress made in patient care and treatment is beyond anything we could have imagined.

“Not only is there now a reliable cure for hepatitis C, but we are also on the verge of eliminating the virus in England.

“Many people who are most at risk of hepatitis C face barriers accessing health services, but the success of the elimination programme so far proves that through innovative partnership working and keeping the patient at the centre, there are ways to reach and treat everyone.

“Since the elimination programme began, England has seen a 37% reduction in deaths from hepatitis C and more than 84,000 people have accessed treatment. Extending the programme ensures the continuation of this remarkable progress and sets the stage for maintaining elimination in the future."

The contract extension and testing investment comes after NHS England introduced a web portal – www.hepctest.nhs.uk – where people can confidentially order self-testing kits to their home.

The test involves a finger prick with a tiny blood sample dropped into a test tube, which is posted to a lab for analysis. Those who receive a positive test result will then be contacted and referred for treatment.

Risk factors for hepatitis C include previous or current injecting drug use, being in the criminal justice system and being born, or have lived, in a country where the bloodborne virus is endemic. 

This includes countries in South Asia and Eastern Europe and where people risk coming into contact with infected blood through medical procedures, blood transfusions and blood products, or equipment used in cosmetic services.