Opt-out HIV and hepatitis testing sees nearly 2,000 diagnoses in first year – it must be expanded, says leading charities

Posted on: 8th June 2023

Today NHS England released the results from the first year of opt-out HIV and hepatitis testing in hospitals in areas with a very high HIV prevalence.

The data shows the programme success is surpassing all expansions and exposing the postcode lottery in hospital testing. The government must fund opt-out HIV testing for the next tranche of A&E departments – high prevalence areas now – as the government’s own guidance recommends, that’s the conclusion of five leading HIV and hepatitis charities.

In just 12 months, more than 1,998 people have been found with HIV, hepatitis B and hepatitis C as a result of opt-out testing 470 of these were people who were previously diagnosed, but were not receiving life changing treatment.

This pioneering approach to testing has saved the NHS millions in care costs because those diagnosed have been able to initiate treatment. Once diagnosed and on effective medication, a person living with HIV can live a long, healthy life and can’t pass on the virus. Hepatitis C can be cleared with medication and treatment can prevent hepatitis B from causing permanent liver damage.

Funding for opt-out testing in the very highest prevalence areas – London, Brighton, Manchester and Blackpool – was allocated as part of the government’s HIV Action Plan in 2021. In February, as a result of campaigning from MPs and council leaders across the country, Public Health Minister Neil O’Brien committed to consider funding for expanding opt-out HIV testing to the next 32 areas and 42 A&Es with a high HIV prevalence. It’s estimated that a further £18 million is needed to implement this for one year.

Scaling up this testing programme is a “no brainer,” according to Terrence Higgins Trust, National AIDS Trust, the Elton John AIDS Foundation, Hepatitis C Trust and the British Liver Trust, who say it’s fundamental to get the country on track to end new cases of HIV and meet ambitious targets on hepatitis.

Pamela Healy, chief executive of the British Liver Trust says: "The first-year data on opt-out testing for hepatitis B and C is clear evidence of its potentially life-saving impact in England. Thousands of individuals live with undiagnosed hepatitis B and C, unaware of their infection as there often no symptoms in the early stages.  If untreated, these viruses can cause liver damage and increase the risk of liver cancer. Finding these individuals through opt-out testing is crucial for their treatment and preventing further transmission.

“NHS data on opt-out testing has revealed a postcode lottery of hepatitis diagnoses, with over 1,000 cases identified in just four cities. Nationwide implementation of opt-out testing could uncover many more cases, saving lives and reducing transmission."