More than half a million people in the UK are estimated to be living with undiagnosed hepatitis B and C, and campaigners say the introduction of testing services in pharmacies could save thousands of lives.
Last year, a viral hepatitis testing pilot project in 19 pharmacies across the nation found a hepatitis B or C positive patient in every six tests conducted. Across the pharmacies, a total of 234 tests were conducted, diagnosing 35 people with hepatitis C (15% of tests) and four people with hepatitis B (2% of tests). This is a far higher proportion of hepatitis C-positive diagnoses than found in GP surgeries, where 4% of tests find positive hepatitis C patients and 2% of tests find hepatitis B patients, says the Hepatitis C Trust which is, with the support of the Royal Pharmaceutical Society of Great Britain, calling for free testing to be introduced in pharmacies.
“It is a tragedy that increasing numbers of people with hepatitis B and C are dying, often from particularly unpleasant liver cancer which these viruses can cause,” says the Trust’s chief executive, Charles Gore. “It is a tragedy because they have generally been living with the virus for years and could have been given treatment at any point, if only they had been diagnosed. So we desperately need new approaches to testing that will find the undiagnosed patients and this pilot study shows pharmacy testing could be just what is needed.”
Call for pilot roll out by PCTs
“If the pharmacy testing pilot is taken as a model and rolled out by PCTs and pharmacies nationally, we can stop people dying needlessly,” he adds.
The pilot programme has ended, but the Isle of Wight continues to offer the tests and has also extended the scheme to include HIV and syphilis tests from the same sample as the viral hepatitis screen.
“This scheme has woken a lot of people up to the problem of viral hepatitis and we are now working with local drug and addiction services in a more integrated way than ever before,” says pharmacist Gary Warner of Regent Pharmacy on the Island. “The results speak for themselves - pharmacies see a different cohort of people to those who see their GP and therefore we can access and diagnose people who otherwise would not have been tested. As an example, the patient that was screened as HIV positive was not someone who would have accessed the test in any other way,” he adds.
The Hepatitis C Trust, supported by the Department of Health, is offering free training to primary care trusts and pharmacists where local services can provide funding for the tests.
According to the Health Protection Agency, there are around 250,000 hepatitis-C positive people in the UK - although some estimates put this number as high as 466,000 - and only around 70,000 people in England and Wales have been diagnosed. The HPA also puts the number of people in the UK living with hepatitis B at 180,000, but the Hepatitis B Foundation estimates that, due to recent immigration trends, this figure is actually 320,000.