Hepatitis C virus (HCV) is estimated to infect around 170 million people worldwide; although it is curable, underdiagnosis means that as few as one in 100 sufferers is receiving the appropriate treatment. Hepatitis B infects around 2 billion people – one in three people worldwide. Of these, many will develop chronic liver disease, resulting in an estimated 1 million deaths a year worldwide from cirrhosis and liver cancer. There are new treatments for Hepatitis B and C. It is important to make an early diagnosis, as this correlates with a better prognosis. There is a specialised team of consultants who manage particularly complex cases, such as those with resistance to previous antiviral treatment and patients with multiviral co-infection. We have a dedicated laboratory on site to process samples for viral drug resistance – an essential component of care.
At the Royal Free, we can use a transjuglar liver biopsy; this is less painful for patients, enables better samples to be taken and involves a hospital stay of six hours or less. Where a liver biopsy is inappropriate, transient elastography (Fibroscan) can be performed. Our specialist nurses act as a link between the consultants and patients and are able to follow patients very closely day to day if necessary whilst they have therapy and in order to give support and advice.