Hepatology · UK
Private liver disease treatment in the UK, under a consultant hepatologist.
Fatty liver, hepatitis B and C, alcohol-related liver disease, autoimmune and cholestatic disease and cirrhosis - staged properly with FibroScan and MRI first, then treated by a named consultant hepatologist.
Indicative pricing
What private liver disease care costs in the UK.
Indicative ranges across our partner hepatology units.
In short
A consultation with FibroScan and a full liver screen: £700–£1,200, and you leave with a stage and a plan.
| Assessment or treatment | Indicative range | Typical duration | Results |
|---|---|---|---|
| Consultant hepatologist consultation | £250–£400 | 45 min | Same visit |
| Non-invasive liver screen (bloods) | £250–£450 | 15 min | 2–5 days |
| FibroScan (transient elastography) | £250–£450 | 15 min | Same visit |
| Liver ultrasound | £250–£400 | 20 min | 24–48 hours |
| Multiparametric liver MRI | £700–£1,200 | 45 min | 48 hours |
| Liver biopsy (day case) | £1,500–£2,800 | 30 min | 5–10 days |
Drug costs sit outside these figures and vary widely - direct-acting antivirals for hepatitis C and GLP-1 therapy for metabolic liver disease are priced separately. Hepatitis B and C treatment is free on the NHS through specialist services, and we will say so plainly when the NHS route is the better one.
The problem
Abnormal liver tests are common. Knowing what they mean is not.
Around one adult in five in the UK has fatty liver, and most find out through a blood test taken for something else. The question that matters is not whether the numbers are abnormal - it is how much scarring sits underneath them.
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Told your liver tests are "a bit off"?
A full non-invasive liver screen plus elastography usually settles both the cause and the stage in a single visit.
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Worried about scarring?
FibroScan gives a fibrosis score without a needle. It is the single most useful test for deciding how worried to be.
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Want the cause treated, not just watched?
Hepatitis C is curable, hepatitis B is controllable, autoimmune disease responds to treatment, and metabolic fibrosis can regress.
When it helps
When a hepatology opinion is the right step.
The presentations we see most often, the ones that turn out to be nothing, and the signs that mean an emergency rather than an appointment.
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Persistently abnormal liver tests
Raised ALT, AST, GGT or ALP that have not settled over three to six months. The commonest reason people are referred, and it deserves a proper cause.
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Fatty liver on a scan (MASLD)
Steatosis reported on ultrasound or CT. Common, often benign, but around one in five has significant fibrosis underneath - elastography tells you which.
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Chronic hepatitis B or C
A positive surface antigen or HCV antibody. Hepatitis C is now curable in over 95 per cent of people with 8 to 12 weeks of tablets.
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Alcohol-related liver disease
Liver injury from alcohol, at any stage from steatosis to cirrhosis. Abstinence changes the outlook more than any drug does.
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Autoimmune and cholestatic disease
Autoimmune hepatitis, primary biliary cholangitis or primary sclerosing cholangitis, usually flagged by autoantibodies and a cholestatic pattern.
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Iron or copper overload
Haemochromatosis with a high ferritin and transferrin saturation, or Wilson disease with a low caeruloplasmin. Both are treatable and both are missed.
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Established cirrhosis
Compensated cirrhosis needs six-monthly cancer surveillance and variceal screening. Done properly, it is a condition you live with for decades.
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Red flag: jaundice, confusion, vomiting blood
Yellow eyes, drowsiness or confusion, black stools or vomiting blood mean decompensation or bleeding varices - A&E the same day, not a clinic booking.
Treatment options
The treatment follows the cause.
What each option actually involves - and which liver disease it belongs to.
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Metabolic liver disease (MASLD/MASH)
Seven to ten per cent weight loss reverses steatohepatitis in most people. Blood pressure, lipids and diabetes are treated hard; GLP-1 agonists and resmetirom are used in selected patients.
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Direct-acting antivirals for hepatitis C
Eight to twelve weeks of well-tolerated tablets, with cure rates above 95 per cent confirmed by a sustained virological response test twelve weeks after finishing.
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Antiviral suppression for hepatitis B
Tenofovir or entecavir taken long term to suppress viral replication, reduce fibrosis and cut liver cancer risk. Not everyone with hepatitis B needs treatment - that is the assessment.
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Immunosuppression for autoimmune hepatitis
Prednisolone or budesonide to induce remission, then azathioprine to maintain it, with transaminases and IgG tracked to biochemical remission.
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Ursodeoxycholic acid for PBC
First-line for primary biliary cholangitis, with obeticholic acid or a fibrate added for the 30 to 40 per cent who do not respond adequately at twelve months.
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Alcohol treatment and relapse prevention
Medically supervised withdrawal where needed, thiamine, and structured relapse-prevention support. Acamprosate or naltrexone are used alongside psychological therapy.
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Venesection and chelation
Regular venesection for haemochromatosis until ferritin normalises, then maintenance. Zinc or chelation therapy for Wilson disease, lifelong.
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Cirrhosis care and surveillance
Six-monthly ultrasound with alpha-fetoprotein for liver cancer, endoscopic variceal screening, beta-blockers for portal hypertension, and early transplant referral when scores shift.
Safety and recovery
What treatment actually asks of you.
Most liver treatment is tablets and monitoring rather than procedures. The risks worth knowing are drug side effects, the things that get missed, and the signs that mean the disease has moved on.
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Fibrosis can regress - but slowly
Remove the cause and scarring often improves over years, not weeks. Early fibrosis reverses far more reliably than established cirrhosis.
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Cirrhosis needs cancer surveillance
Hepatocellular carcinoma risk runs at roughly one to four per cent a year in cirrhosis. Six-monthly ultrasound is what makes it curable when it happens.
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Steroid side effects in autoimmune disease
Weight gain, bone thinning, glucose rise and mood change. Bone protection and a steroid-sparing agent are planned from the start, not added later.
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Azathioprine and TPMT testing
TPMT activity is checked before starting azathioprine, and blood counts are monitored, because marrow suppression is the risk that matters.
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Drug interactions with antivirals
Direct-acting antivirals interact with statins, amiodarone, some anticonvulsants and St John’s wort. A full medication review comes before the first tablet.
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Hepatitis B reactivation risk
Chemotherapy, rituximab or steroids can reactivate hepatitis B, sometimes fatally. Anyone due immunosuppression should be screened first.
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Alcohol and paracetamol in liver disease
Alcohol has no safe amount in established liver disease. Paracetamol is usually safe at a reduced dose; NSAIDs are best avoided in cirrhosis.
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Vaccination and infection
Hepatitis A and B, pneumococcal, influenza and COVID vaccination are recommended in chronic liver disease. Spontaneous bacterial peritonitis is the infection to know about in ascites.
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Red flags between appointments
Jaundice, new confusion or drowsiness, abdominal swelling, black stools or vomiting blood - call the liver team or go to A&E the same day.
Reading your liver report
Your liver report in four parts. Read the last one first.
Whether the result is a FibroScan reading, a biopsy report or a set of blood tests, the letter your hepatologist sends keeps to the same shape.
A quiet reminder
Hepatology language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the report before your review, just ask.
- 01 Header
Indication and background
Why you were tested - abnormal LFTs, a scan finding, a known virus - and the history, alcohol intake and medications the hepatologist worked from.
- 02 Technique
What was measured and how
Which blood tests, imaging and elastography were used, the FibroScan kPa reading and IQR, and whether the study was technically adequate.
- 03 Findings
Cause and fibrosis stage
The named diagnosis and the fibrosis stage, usually as F0 to F4, along with any steatosis grade (CAP score) and other findings on imaging.
- 04 Impression
Plan, surveillance and review
Read this first: what is being treated, what is being monitored, how often, and what would change the plan.
Recognised by major UK insurers
Cover for liver disease investigation is usually funded when medically indicated. Diagnostic work-up, elastography and specialist consultations are generally in scope; long-term drug therapy and chronic disease monitoring often are not, because most policies exclude chronic conditions.
Frequently asked
Everything we get asked about liver disease treatment.
Quick answers on staging, whether damage reverses, what each cause needs, and when the NHS route is simply the better one.
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Can liver damage be reversed?
Often, yes. The liver regenerates well, and fibrosis regresses once the cause is removed - hepatitis C cured, alcohol stopped, weight lost, iron unloaded. Early and moderate fibrosis reverses most reliably. Established cirrhosis can improve and stabilise, but the architectural change is largely permanent, which is why the surveillance continues either way.
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What is a FibroScan and do I need one?
FibroScan is transient elastography - a painless probe on the right side of the chest that measures liver stiffness in kilopascals, and fat content as a CAP score. It stages fibrosis without a needle and takes about ten minutes. For anyone with abnormal liver tests or fatty liver, it is usually the single most informative test available.
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Is hepatitis C really curable?
Yes. Direct-acting antivirals cure more than 95 per cent of people with eight to twelve weeks of well-tolerated tablets, and cure is confirmed by an undetectable viral load twelve weeks after treatment finishes. Treatment is free on the NHS through specialist hepatitis services, and we will point you there when that is the better route.
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How much does private liver disease care cost in the UK?
A consultant hepatologist consultation runs £250–£400, a full non-invasive liver screen £250–£450, and FibroScan £250–£450. A multiparametric liver MRI is £700–£1,200 and a day-case liver biopsy £1,500–£2,800. Drug costs sit outside these figures.
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What is MASLD and how is it different from NAFLD?
MASLD - metabolic dysfunction-associated steatotic liver disease - is the current name for what used to be called NAFLD. The renaming in 2023 shifted the definition from ruling out other causes to positively identifying a cardiometabolic driver such as obesity, type 2 diabetes, high blood pressure or dyslipidaemia. MASH is the inflammatory form that drives fibrosis.
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Do I need a liver biopsy?
Far less often than a decade ago. Non-invasive tests - elastography, ELF, FIB-4 and multiparametric MRI - settle most cases. A biopsy is reserved for uncertain diagnoses, mixed or overlapping causes, suspected autoimmune disease, and where the result would genuinely change treatment.
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How much alcohol is safe if my liver tests are abnormal?
The UK guideline of fourteen units a week applies to healthy adults. If there is established liver disease, particularly alcohol-related disease or cirrhosis, the honest answer is none. In simple fatty liver without fibrosis, staying well within fourteen units and having several alcohol-free days is the usual advice.
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What surveillance do I need if I have cirrhosis?
Six-monthly ultrasound, usually with alpha-fetoprotein, for hepatocellular carcinoma; endoscopy to screen for oesophageal varices at diagnosis and then on an interval set by what is found; and regular bloods to track synthetic function. It is this surveillance, more than anything, that changes outcomes.
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Will you tell me if the NHS is the better option?
Yes, and we do it often. Hepatitis B and C treatment, transplant assessment and complex autoimmune or cholestatic disease all sit within excellent NHS specialist services that are free at the point of use. Private care is most useful for speed of diagnosis, choice of consultant and access to elastography and MRI without a wait.
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When should I go to A&E rather than book a clinic?
New jaundice, confusion or unusual drowsiness, vomiting blood, black tarry stools, rapidly swelling abdomen or a fever with known cirrhosis all need urgent assessment the same day. Those are emergencies, not appointments.
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