Following sustained campaigning by leading health charities including the British Liver Trust, the Terrence Higgins Trust, and Hepatitis C Trust, the UK Government have announced a £20 million investment into vital research on the effectiveness of opt-out testing for HIV and viral hepatitis in emergency departments.
The opt-out testing programme will now be expanded to 46 A&Es across England in 33 areas such as Birmingham, Portsmouth, Derby and Peterborough(1). The programme aims to identify over a quarter of a million people in the UK who are estimated to be undiagnosed with viral hepatitis in the UK – a silent killer which increases the risk of fatal liver damage including cirrhosis and liver cancer.
Welcoming the announcement, British Liver Trust Policy Director, Vanessa Hebditch , said “If undetected, viral hepatitis is a silent killer which can cost lives and cause fatal liver complications. The £20 million investment is a crucial next step by the UK Government to meet our global commitment to eliminate Hepatitis B as a public health threat by 2030.”
Adding “Testing people in emergency departments has proven highly effective and needs to be extended nationwide to not only save lives and reduce health inequalities but also to relieve huge pressures on our NHS. The programme has also demonstrated that the UK has a much higher prevalence of hepatitis B and there needs to be a sustained focus by policy makers to address this virus and make sure people have access to the care that they need.”
Since the launch of the opt-out testing programme in April 2022 in London, Brighton, Manchester and Blackpool, almost three quarters of a million people (730,137) have been tested for Hepatitis B (HBV) of which 2,206 people were identified as living with HBV.
UK Health Security Agency analysis suggest prevalence is far higher than initially expected. Approximately 180,000 people are estimated to be chronically infected with Hepatitis B and in some inner-city areas, as many as one in 60 pregnant women may be affected(2).
The opt-out testing programme in emergency departments has enabled NHS England to better identify and treat thousands more people living with HIV, Hepatitis B and Hepatitis C, particularly from disadvantaged groups which are less likely to come forward for routine testing.
Hepatitis B disproportionately affects marginalised communities including migrants who acquired the condition from endemic countries in Sub-Saharan Africa and the Western Pacific before moving to the UK. LGBT people, sex workers and people in detention and people experiencing homelessness are also at higher risk for both Hepatitis B and C(3).
(2) https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/113381, https://britishlivertrust.org.uk/emergency-department-opt-out-testing-thousands-tested-and-diagnosed-with-hiv-hepatitis-b-and-hepatitis/3/Hepatitis_B_in_England_2023.pdf, https://www.gov.uk/government/publications/bloodborne-viruses-opt-out-testing-in-emergency-departments