Hepatitis B and C affect hundreds of thousands of people in the UK. Hepatitis C can now be cured with a short course of tablets in over 95% of cases — one of modern medicine's greatest triumphs. Hepatitis B, however, still requires lifelong treatment for most patients, and a "functional cure" remains elusive. Meanwhile, new research into liver fibrosis reversal, fatty liver disease, and autoimmune hepatitis is expanding the trial landscape significantly.
The UK has world-class hepatology research centres, with the NIHR Hepatology specialty leading multi-centre trials. The NHS England Hepatitis C Elimination Programme — aiming to eliminate HCV as a public health concern by 2025 — has created a research-ready infrastructure that is now being applied to HBV and other liver diseases.
Currently, there are over 90 actively recruiting hepatitis and liver disease trials in the UK. The most exciting area is hepatitis B functional cure research, with multiple novel approaches in Phase 2 and 3 trials.
Types of Hepatitis Trials
HBV Functional Cure
siRNA therapies, capsid assembly modulators, therapeutic vaccines, and combination approaches targeting hepatitis B surface antigen (HBsAg) loss.
HCV Optimisation
Shorter treatment courses, re-treatment strategies for DAA failures, and simplified point-of-care testing for elimination programmes.
Liver Fibrosis
Anti-fibrotic agents, MASH/NAFLD therapies, and strategies to reverse liver scarring in chronic hepatitis.
Co-infection Studies
HIV/HBV, HIV/HCV, and HDV co-infection trials addressing the complex treatment needs of patients with multiple viral hepatitis infections.
Hepatitis B: The Quest for a Functional Cure
Over 180,000 people in the UK live with chronic hepatitis B. Current treatment (nucleos(t)ide analogues like tenofovir and entecavir) suppresses the virus effectively but rarely eliminates it, meaning most patients need lifelong medication. A "functional cure" — defined as sustained HBsAg loss with or without seroconversion — is the goal of intensive research:
siRNA therapies (bepirovirsen, VIR-2218) — small interfering RNA molecules that silence HBV gene expression, dramatically reducing viral antigens. Multiple Phase 2 trials are active in the UK
Capsid assembly modulators — drugs that disrupt the formation of new HBV viral particles, being tested in combination with NA therapy
Therapeutic vaccines — therapeutic vaccination aiming to restore immune control over HBV, enabling patients to stop NA therapy while maintaining viral suppression
Pegylated interferon combinations — combining modern NA therapy with interferon to boost HBsAg loss rates
Novel entry inhibitors — blocking HBV from infecting new hepatocytes, useful for prevention of re-infection after liver transplant
The most promising approach is combination therapy — pairing siRNA with capsid inhibitors, therapeutic vaccines, or interferon to achieve functional cure rates significantly higher than any single agent alone.
Hepatitis C: Cure Optimisation and Elimination
Direct-acting antivirals (DAAs) have transformed hepatitis C from a chronic, progressive disease into a curable condition. UK trials are now focused on optimisation and elimination:
Ultra-short treatment courses — testing 4-week and even 2-week DAA regimens that could make treatment faster and cheaper
Re-treatment after DAA failure — for the small percentage of patients whose virus develops resistance, new combination regimens are being tested
Point-of-care diagnostics — trials validating rapid HCV testing in community settings (pharmacies, drug services, prisons) to find undiagnosed patients
Micro-elimination strategies — targeted testing and treatment in high-risk populations: people who inject drugs, prison populations, and South Asian communities
Post-cure follow-up — long-term studies on liver health after HCV cure, including fibrosis regression and cancer risk reduction
Liver Fibrosis and MASH/NAFLD Research
Metabolic dysfunction-associated steatohepatitis (MASH, formerly NASH) is rapidly becoming the leading cause of liver disease in the UK, driven by obesity and type 2 diabetes. Active trials include:
Resmetirom (Rezdiffra) — the first FDA-approved MASH treatment, now in UK trials for broader populations and long-term outcomes
GLP-1/GIP agonists for MASH — semaglutide and tirzepatide showing significant liver fat reduction and fibrosis improvement
Anti-fibrotic agents — targeted therapies to reverse liver scarring, including cenicriviroc and belapectin
FXR agonists — obeticholic acid and next-generation farnesoid X receptor agonists for liver inflammation and fibrosis
Combination approaches — pairing anti-inflammatory with anti-fibrotic agents for synergistic benefit
Autoimmune Hepatitis and Rare Liver Diseases
Beyond viral hepatitis, UK trials address autoimmune and rare liver conditions:
Primary biliary cholangitis (PBC) — next-generation therapies for patients with incomplete response to ursodeoxycholic acid (UDCA), including elafibranor and seladelpar
Primary sclerosing cholangitis (PSC) — a condition with no approved treatment, now seeing multiple Phase 2 trials including anti-fibrotic and anti-inflammatory approaches
Hepatitis D (HDV) — the most severe form of viral hepatitis, with bulevirtide and lonafarnib showing promise in UK trials
Wilson disease — novel chelation approaches and gene therapy for this rare copper metabolism disorder
Liver Cancer Surveillance Trials
Patients with chronic hepatitis B or C are at elevated risk of hepatocellular carcinoma (HCC). UK trials are improving surveillance:
Liquid biopsy for early HCC detection — blood-based biomarkers (cfDNA, protein panels) for earlier cancer detection than ultrasound
AI-enhanced imaging — machine learning algorithms to improve HCC detection on surveillance MRI and ultrasound
Risk stratification — identifying which hepatitis patients are at highest cancer risk to target surveillance more effectively
Who Can Participate?
Eligibility varies by trial type:
HBV trials — confirmed chronic HBV (HBsAg positive for ≥6 months), often requiring specific viral load or HBsAg levels, on or off NA therapy
HCV trials — confirmed HCV RNA positive (for treatment trials) or documented SVR (for post-cure studies), specific genotype requirements
Liver fibrosis trials — documented fibrosis stage (by FibroScan, biopsy, or serum markers), with specific stage requirements (F2-F3 for most trials)
Liver function — compensated liver disease (Child-Pugh A) for most trials; decompensated trials available for advanced disease
Treatment history — some trials require NA-naïve status; others require failure of prior therapy
Age requirements — typically 18–75 for adult trials
💡 Tip: Get Your Viral Load and Fibrosis Results
Before searching for hepatitis trials, gather: your hepatitis genotype (B or C), viral load (HBV DNA or HCV RNA), liver function tests (ALT, AST, bilirubin), fibrosis assessment (FibroScan score or biopsy result), and current medication list. These are essential for determining eligibility and matching you to the right trial.
UK Hepatitis Trial Locations
Major UK centres running hepatitis trials include:
London — King's College Hospital (one of Europe's largest liver units), Royal Free Hospital, St Mary's Hospital, Barts Health
Birmingham — University Hospitals Birmingham, Queen Elizabeth Hospital liver unit
Edinburgh — Royal Infirmary of Edinburgh, Edinburgh Liver Unit
Glasgow — Queen Elizabeth University Hospital, Brownlee Centre
Leeds — St James's University Hospital, Leeds Liver Unit
Manchester — Manchester Royal Infirmary, The Hepatology Research Unit
Newcastle — Freeman Hospital, Newcastle upon Tyne Hospitals liver research
Cambridge — Addenbrooke's Hospital, Cambridge Liver Unit
How to Find Your Match
Use our Smart Matcher to find hepatitis trials tailored to your hepatitis type, genotype, and liver health. Whether you have hepatitis B and are looking for functional cure trials, hepatitis C and need re-treatment, or liver fibrosis from any cause, we can match you to actively recruiting studies.
Browse our hepatitis condition page for all recruiting studies, or explore related conditions like HIV (common co-infection) or CKD if you have kidney involvement.
Find Hepatitis Trials For You
Our Smart Matcher uses your hepatitis type, genotype, and liver health to find the most relevant clinical trials.