Hepatitis test and treat successfully rolled out in Edinburgh prison

World Hepatitis Day is observed each year on 28 July to raise awareness of viral Hepatitis, an inflammation of the liver that causes severe liver disease and liver cancer.

The World Hepatitis Day 2026 theme, “Hepatitis: Let’s break it down,” is a call to remove the barriers that stand between people and the services that can save their lives. Viral Hepatitis continues to be a major cause of preventable illness and death worldwide.

In Scotland, Lothian’s Viral Hepatitis Managed Care Network (MCN) continues to coordinate work towards the elimination of Hepatitis as a public health concern.

From April to June 2024, the Scottish Government awarded funding to NHS Lothain to deliver a pilot project of opt-out blood-born virus (BBV) testing in one Emergency Department. BBV testing includes testing for Hepatitis B and C, as well as testing for HIV.

Due to a surplus of funding, representatives, in partnership with NHS Lothian and The Hepatitis C Trust, agreed to use the funding to bring the pilot testing to HMP Edinburgh.

People who live in prison are at increased risk of viral hepatitis. The offer of opt-out testing is already established on entry to prison but uptake varies and there may be a risk of BBV infection while in prison. 

A HITT involves the mass offer of BBV testing over a short, agreed time frame. Treatment is quickly put in place for those who test positive for any infection(s), halting onward spread of infections within the population.

The HITT process in HMP Edinburgh was spread over 3 days. Across Days 1 and 2, skill-mixed teams delivered BBV testing across prison wings using Dried Blood Spot Testing, with residents engaged, consented, tested, or documented if they declined.

Teams followed agreed movement plans based on risk and environment, maintained infection control standards, and sent completed samples daily to the RIE laboratory.

On Day 3, a smaller team completed mop-up testing, revisited residents who were missed or declined, arranged re-sampling where required, and the team managed and recorded confirmed results on HMP Vision.

836 BBV tests were conducted over the period of HITT, giving an initial uptake rate of 89%. The uptake was later amended to 86% to account for resampling.

In total, there were 105 positive antibody tests and 14 positive PCR tests for Hepatitis C. There were 5 positive tests for Hepatitis B.

The BBV treatment team dedicated extra clinics for follow up of the event. Everyone was offered an initial appointment the week after the HITT. 

After the HITT, researchers conducted evaluations with residents and staff.

The evaluations found that residents were generally positive about the HITT and BBV testing, with some saying it reduced stigma and encouraged them to access other healthcare. Residents valued clear verbal communication, trusted/familiar staff, and awareness-raising by The Hepatitis C Trust, though views varied on testing at admission and the use of small incentives.

Staff and partners also reported very positive experiences, highlighting strong partnership working, teamwork, and high resident engagement. Key learning included improving planning logistics, preparing test kits in advance, and using pre-printed labels to reduce errors and save time. Overall, the HITT was seen as a successful, collaborative effort that strengthened relationships and supported stigma reduction.

Off the back of this success, there was another HITT event at Addiewell Prison, West Lothian in March and April 2025 and the report for this will be finalised in due course.

In addition, HMP Edinburgh launched a peer-led testing project in April 2026 and is due for review at the beginning of August but has been well received overall. The review will hopefully lead to this being rolled out in Addiewell Prison later this year.

World Hepatitis Day 2026

Scottish Prison Service

Hepatitis C Trust