A&E testing scheme finds thousands of people with HIV and hepatitis

June 07, 2023

A £20m NHS pilot scheme in A&E departments has helped diagnose thousands of people with HIV and hepatitis.

The pilot, which has been running since April 2022 in 33 hospital emergency departments across the UK, has seen patients in routine blood tests offering additional samples which are then screened for HIV, hepatitis B and hepatitis C.

The scheme, which will run over the next three years, is "opt-out" - meaning that all patients over the age of 18 are tested unless they decline the screening.

According to NHS England, the pilot has allowed almost 2,000 people to be diagnosed and has offered around 470 people who had been diagnosed but were not receiving care to be identified and offered treatment.

Professor Sir Stephen Powis, NHS national medical director, said, "Effective testing for blood-borne viruses is vital in helping us identify and treat more people living with HIV and hepatitis, so we are very pleased with the positive impact of our routine opt-out testing programme.

"Increasing the early detection and diagnoses of HIV, hepatitis and other blood-borne viruses, enables us to provide people with better access to the latest and most effective life-saving medication, which can prevent long-term health issues and reduces the chance of unknown transmissions to others."

In 2018, the Elton John AIDS Foundation introduced opt-out HIV testing in south London under the world's first social impact bond, which focused on giving people living with HIV access to appropriate care. Over three years more than 265,000 people received HIV testing and more than 460 south Londoners living with HIV entered treatment for the first time.

Anne Aslett, chief executive at the Elton John AIDS Foundation, said: "When the Elton John AIDS Foundation first piloted opt-out HIV testing in emergency departments in south London, the results were not only staggering, they also paved the way for opt-out HIV testing to go country wide.

"Since opt-out testing in the highest prevalence areas began last April, the system has diagnosed people from the ages of 18 to 85. It has been incredible to see how opt-out testing has changed the lives of people living with HIV."

According to NHS data, 42% of HIV diagnoses in the UK occur when the patient's immune system is already significantly compromised.

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Research shows that those who receive a late diagnosis are eight times more likely to die from the illness.

Richard Angell, chief executive at Terrence Higgins Trust, said expanding testing for HIV and hepatitis in A&E was "essential" to the organisation meeting its goal of ending new HIV cases by 2030.

He added: "The results from one year of opt-out testing in areas with very high HIV prevalence are above and beyond
what anyone expected and have demonstrated an incredible return on investment."

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