Thousands of new HIV and Hepatitis cases identified thanks to NHS testing pilot

Almost 2,000 people living with HIV and Hepatitis who were previously undiagnosed have been identified by the NHS over the last year, thanks to a new testing pilot.

Under the NHS programme, people visiting an A&E who are having blood taken as part of their visit have an extra sample of blood taken, which is screened for HIV, Hepatitis B and Hepatitis C.

If the test comes back positive for HIV or Hepatitis B or Hepatitis C, the patient is offered specialist support and a treatment plan is agreed with them.

Around 470 people living with blood borne viruses, such as HIV or hepatitis B or C, who were previously diagnosed, but not receiving NHS care, were identified following emergency department testing; and given the chance to complete treatment.

The NHS has invested £20 million over three years to implement routine HIV opt out testing programme within 33 hospital emergency departments, in areas with the highest rates of diagnosed prevalence of HIV, starting in April 2022.

Data shows more than two fifths (42%) of HIV diagnoses in the UK are made late, at a point when the immune system has already been significantly damaged. Research suggests that people who get a late HIV diagnosis are eight times more likely to die from the illness, so early identification is key in preventing ill-health, premature death and onward transmission.

During the last 12 months, the NHS has struck a series of deals for the latest HIV drugs, including a long-acting injection and the first oral drug to combat the disease, as part of its ambition to become the first country in the world to stop new cases of HIV before 2030.

The NHS England Hepatitis C Elimination programme has recently launched an online service where people can order self-testing kits, to accelerate progress towards elimination of the virus as a public health threat in the country.

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.

“The NHS is committed to making all contact with patients count, and this testing programme is a good example of how we are taking advantage of every opportunity to support people with staying well, preventing illness and saving lives.”

One person who has benefited from routine HIV testing in ED is Oliver Brown from London.

Oliver said: “I was 29 when I went to A&E after coming off my bike with one of my fingers badly sliced during the fall.

“Had Chelsea and Westminster Hospital not been part of a routine HIV opt-out testing programme in Emergency Departments, I may still be unaware of my status.

“As a naval officer, I faced challenges following my diagnosis, fearing the stigma associated with being HIV positive. However, through engaging and educating, the blanket ban on people with HIV being able to serve our country has been lifted and now individuals taking medications such as ART and PrEP are recognised as fully fit to serve in our Armed Force.

“Routine opt-out testing in A&E departments saves lives, it saved mine and stopped me passing on the virus to others.”

As part of England’s HIV Action Plan, the NHS is working to ensure that the estimated 4,660 people living with the virus but unaware of their HIV status, are tested, diagnosed, and offered treatment.

Richard Angell, Chief Executive at Terrence Higgins Trust, said: “The expansion of A&E HIV and hepatitis testing is essential to reaching our life-changing goal of ending new HIV cases by 2030. 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.

“In fact, the NHS data shows that if there had been funding in all hospitals where the government’s own guidance recommends opt-out testing takes place, an additional 500 people would be newly diagnosed with HIV or returned to care.

“We want to see opt-out HIV and hepatitis testing implemented in all areas with high HIV prevalence to make sure we can find and diagnosed people with HIV, hepatitis B and hepatitis C across England and ensure they are accessing the care they need.”

Anne Aslett, Chief Executive at 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.”