Viral Hepatitis

The Department of Hepatology provides a comprehensive service for patients with hepatitis B and hepatitis C. The service is multi-disciplinary and includes consultants in infectious diseases and sexual health as an integral part.

GPs are encouraged to refer all new patients with hepatitis B or C to this service through Choose and Book (Viral Hepatitis). There is appropriate expertise in this clinic for patients co-infected with either virus or other blood borne viruses such as HIV. Third sector and public health services can refer to this clinic directly using a proforma available on Leeds Health Pathways. We also provide an in-reach service to local prisons.

The medical clinic is held weekly on Thursday afternoons. It is a teaching and training clinic. Fibroscan technology is available in this clinic if needed.

The Specialist team

The Hepatology viral hepatitis team comprises the following staff members:

Leeds Teaching Hospitals NHS Trust

• Dr Mark Aldersley (Service lead; Consultant Hepatologist)
• Dr Emma Page (Consultant Sexual Health)
• Dr Victoria Appleby (Consultant Hepatologist)

Team Leader

• Catherine Wigglesworth

Senior Clinical Nurse Specialist

• Tracey Stirrup

Clinical Nurse Specialists

• Rosa Maunganidze (Hep B & C)
• Joan Williamson (Prisons Specialist)
• Samantha Sharman (Prisons Specialist)
• Liz Nother (Vulnerable Groups Specialist)
• Sara Steveson (Hep B)

Nurse Associate

• Sheila Passmore (Vulnerable Groups Specialist)

Pharmacist

• Sandeep Whitehead Advanced Clinical Pharmacist

Secretarial /Admin support for CNS team

• Patricia Shaw

MDT Coordinators & CNS Support

• Natalie Embleton

West Yorkshire ODN Network Manager

• Diane Williams

West Yorkshire ODN Project Assistant/Data Support

• Daljinder Shoker 
• Nasrina Masoud (Business Admin Apprentice)

Hepatitis B

A nurse led service was established in May 2012 and provides care and support for patients with both acute and chronic hepatitis B.

The service is committed to providing the highest possible standards of care. Treatment is offered to patients in line with current guidelines (for example those from the European Association for the Study of the Liver [EASL] and the National Institute for Clinical Excellence [NICE]), following discussion at multidisciplinary team meetings.

We actively promote public health in Leeds providing a vaccination programme for at risk new-born babies and working in partnership with Leeds Health protection to promote screening in high risk population groups.

The Clinical nurse Specialist offers both face to face and telephone consultations.

“Very helpful, arranges ultrasound and appointment together saving me multiple journeys to hospital.”

“Great having a named individual who I can communicate with and see everytime.”

“Explains things so I can understand.”

About Hepatitis B

General Information

Hepatitis B is a viral infection that attacks the liver. The infection can be acute (short lived) or it can become chronic (longer than 6 months) and if left untreated can cause liver damage and liver cancer.

It can affect people of any age or race, but it is common in China,Hong Kong,Vietnam and other Asian countries. It is important to consider being tested, if you were born in or if one of your parents were born in one of these countries.

How does Hepatitis B spread?

The virus is transmitted through contact with blood or other body fluids (saliva, semen and vaginal secretions) of an infected person. It can not be caught from normal social contact such as sharing plates and cutlery or holding hands.

Common ways of passing on the virus include:

• Mother to baby at birth
• Unprotected sex (oral, vaginal or anal)
• Sharing razors or toothbrushes
• Sharing needles for drugs
• Tattoos or piercings if equipment not sterilised properly

What are the symptoms of Hepatitis B?

Many people do not have any symptoms and often do not know that they have the virus. Symptoms of acute infection may include fever, nausea, abdominal pain or jaundice. Chronic infection may not have any symptoms until it has caused scarring of the liver, a condition called cirrhosis. The virus may also lead to liver tumours known as hepatocellular carcinoma or HCC.

Can Hepatitis B be treated?

Treatment is not a cure but aims to suppress virus replication and improve quality of life. Not everyone requires treatment but if the virus is causing damage to your liver, then safe and effective treatment is available. If you are referred to the service in Leeds, you will be monitored in clinic regularly and may require a liver biopsy or liver fibroscan to help the doctor decide which treatment would be best for you.

• Treatments available through the Service in Leeds are:
• Pegylated interferon (a weekly subcutaneous injection)
• Oral antiviral tablets (NUCs)

A member of the team will discuss the most appropriate treatment for you. It is important to attend for regular checkups to monitor your response to treatment.

Hepatitis C

About Hepatitis C

Hepatitis C (HCV) is a virus that can cause liver disease. Generally the virus is transmitted by blood-to-blood contact and before the introduction of screening donated blood in 1991, it was also spread through blood transfusions. HCV can be acquired by people who inject drugs through the sharing of needles and other injecting paraphernalia (gear) and there is a small risk of infection associated with tattooing, electrolysis, body piercing, acupuncture and sexual intercourse. There is a transmission rate of about 6% at birth from mother to child if the mother is a HCV carrier (NICE 2004).

Prevalence in the UK population is estimated at 0.4% to 1% (DOH 2004).

Current treatment is with NICE (National Institute for Clinical Excellence) approved therapies. The treatment options and length of treatment is dependent upon many factors such as the strain of the virus, viral load, age and damage to the liver, and these factors  can also affect the response to treatment and the chance of success.

Hepatitis C Service

Outpatient services for hepatitis C patients are provided through the Viral Hepatitis Clinic. This is a multi-disciplinary clinic delivered by specialists in Hepatology, Sexual Health and Infectious Diseases, supported by expert specialist nurses and pharmacists. Patients referred to the Viral Hepatitis Service will have a liver fibroscan performed at their assessment appointment either in the medical clinic or with the nurse. The hepatitis C service is one of the largest treatment centres in the UK, treating up to 180 patients a year, including those who are treatment naive, for retreatment, or pre- or post-transplant, with the latest NICE approved drugs.

The team of nurse specialists are a dedicated team providing expert care to patients before, during and after treatment. The team are committed to provide the best practice to optimise treatment outcomes for patients with the support of the Consultant Hepatologists.

Our hepatitis C service was highly commended in the Leeds Teaching Hospitals “Time to Shine” awards in 2016.

Referral to this service is through the Viral Hepatitis clinic at St. James’s University Hospital. Referral guidelines can be found on Leeds Health Pathways (accessible via an N3 connection).

The Leeds Liver Unit hosts the regional Operational Delivery Network for West Yorkshire and Airedale and works closely with other hospitals within the network to ensure that patients around our region have good access to hepatitis C treatments. Patients are discussed in our multidisciplinary team meeting.

We were awarded ‘The Health Equalities Award’ on 7 July 2021 by the UK Parliament.