Thousands of people living with undiagnosed HIV and hepatitis C and B have been found through NHS England’s opt-out emergency department testing, according to an evaluation report of the programme by the UK Health Security Agency (UKHSA).
More than 7m BBV tests were conducted in A&E departments across 34 areas with high HIV prevalence, with people tested for hepatitis B and C as well as HIV unless they chose to opt out. The testing – which had an uptake rate of 70 per cent – identified 719 new HIV diagnoses, 831 new hep C diagnoses and 3,667 new hep B diagnoses over the 33-month evaluation period to January 2025.
The A&E tests represented around half of the BBV testing carried out in the areas during this time, with more than 60 per cent of those tested having no previous record of BBV testing. Those who received a diagnosis were then offered treatment and support, says UKHSA.
Half of the people newly diagnosed with HIV had late-stage disease – ‘substantially higher’ than in other healthcare settings and suggesting that opt-out A&E testing was ‘a “safety net” for finding people living with HIV who were not identified in other health care services’, the agency states. Almost 300 people who’d previously been diagnosed with HIV were relinked to HIV care, it adds.
Twelve per cent of those newly diagnosed with hep C were also diagnosed at a late stage of liver disease, with a St Mungo’s report earlier this year stating that people experiencing homelessness were one of the most at-risk groups for hep C infection.
‘The pioneering NHS opt-out testing programme in emergency departments is helping us reach thousands of people who did not know they were living with HIV, hepatitis B or hepatitis C,’ said deputy director of UKHSA’s Blood Safety, Hepatitis, STI and HIV Division, Dr Sema Mandal. ‘Many of these individuals might never have been tested otherwise – missing the chance to access life-saving treatment. What we’re seeing is a clear and urgent need to do more to tackle these serious infections.’
The high number of new diagnoses showed ‘just how many people are living with undiagnosed bloodborne viruses’, she continued. ‘We must improve awareness, expand testing and diagnosis and ensure people are supported into care and treatment. Early diagnosis can help prevent years of ill health and save thousands of lives.’
Bloodborne viruses (BBVs): opt-out testing in emergency departments (EDs) available here