More than a quarter of a million people in England could be living with a serious liver infection, health chiefs have warned. 

Hepatitis B, dubbed the 'silent disease' or hep B, was previously thought to only affect around 206,000 adults nationwide. 

But officials at the UK Health Security Agency (UKHSA) found the figure is almost a third higher at an estimated 268,767 — or one in 200 people in England, with majority undiagnosed. 

However, rates of the virus, which is spread via contaminated blood, more than doubles to over one in 100 people in London. 

Experts today argued it was 'essential' health chiefs take urgent action to address the condition, particularly as many people won't even be aware they are infected. 

Hepatitis B has few noticeable symptoms in the early stages but if left untreated it can lead to serious liver disease, including liver cancer and can even prove fatal years after the initial infection. 

Latest UKHSA data suggests cases are highest among those aged between 30 and 49, at an estimated 128,695. 

People over the age of 50 followed, with an estimated 85,292 cases. 

While diagnoses of new cases hep B decreased between 2019 and 2021, they've since returned to pre-pandemic levels.

It comes as the Government recently revealed that a pilot programme testing for blood borne viruses in A&E departments has led to 646 people being diagnosed with hepatitis B in its first year of operation.

'It has put a spotlight on the scale of undiagnosed hepatitis B infections in the community and the need to expand access to testing,' UKHSA said. 

There are now plans to expand this testing programme from 33 sites nationwide, to include an additional 47. 

Chief executive of charity the British Liver Trust, Pamela Healy, said: 'Testing people in emergency departments has demonstrated the scale of the problem that needs to be addressed.

'Thousands of individuals are living with undiagnosed hepatitis B, unaware of their infection. 

'Many people who are at risk and those living with the condition avoid seeking treatment due to fear of stigma and misconceptions, especially since there are often no symptoms in the early stages. 

'It is essential to raise awareness and provide accurate information to encourage testing and treatment.'

A survey by the British Liver Trust this month also found just 2 per cent of people were able to name hepatitis as a risk factor for liver disease. 

Health officials have long agreed most of the cases in England are among migrants who have acquired the infection overseas before coming to the UK.

Communities at higher risk of getting the infection in the UK include people who inject drugs, gay, bisexual and men who have sex with men, sex workers and people in prisons or immigration detention centres.

One of the most common routes of infection globally is from women passing it to babies during birth.

Since the late 1990s, all pregnant women in England have been offered an antenatal blood test for hep B.

Around 2,000 women every year test positive for hep B in England and their babies are offered the hep B vaccine from birth.

Hepatitis, of which there are multiple types, often has no noticeable symptoms.

But signs of the infection include dark urine, pale grey-coloured faeces, itchy skin and the yellowing of the eyes and skin.

Infected people can also suffer muscle and joint pain, a high temperature, feeling and being sick and being unusually tired all of the time, according to the NHS. 

Experts warn, however, that living with hepatitis B 'often subjects people to stigma meaning fewer people come forwards for potentially life-saving treatments'.

Dr Ahmed Elsharkawy, a consultant hepatologist at University Hospital Birmingham NHS Trust said: 'The lack of awareness and the stigma surrounding hepatitis B and C are significant barriers to treatment. 

'We need to create an environment where people feel safe to come forward for testing and treatment. 

'Education is key to dispelling myths and reducing the stigma associated with these infections.'

The NHS is set to eliminate another type of hepatitis, hepatitis C (hep C) by 2025 – five years ahead of the World Health Organization's target.

Deaths from hep C in England have fallen by 35 per cent in six years, well-exceeding the target of 10 per cent. They are also at their lowest level in 20 years.