NHS to expand opt-out HIV and hepatitis testing

The NHS will automatically test patients for HIV, Hepatitis B and Hepatitis C unless they opt out at almost 90 Accident and Emergency (A&E) units in England, the BBC can reveal.

The government is rolling out a £27m expansion of the scheme to 30 new hospitals, saying it could lead to an extra 1,900 people receiving earlier care for HIV each year.

NHS England data showed a 40% rise in the detection of blood-borne infections after the last Conservative government began piloting the scheme in November 2023.

NHS chief executive Amanda Pritchard said the "expansion of this revolutionary opt-out testing" will lead to the early detection of "thousands more cases of HIV and Hepatitis B and C".

The announcement means the scheme will be available in nearly all areas of England.

It is designed to catch cases of blood-borne viruses in people who would not usually get tested at a sexual health clinic.

NHS England data shows opt-out testing has caught 7,300 cases of newly-diagnosed blood-borne viruses, including more than 1,000 cases of HIV, 4,600 of Hepatitis B and 1,600 of Hepatitis C.

Previously expanding the scheme to 59 hospitals led to a 43% surge in detected infections over 10 months compared to the same time period two years earlier.

HIV stands for Human Immunodeficiency Virus - the immunodeficiency is the weakening of the immune system by the virus. If untreated, it can lead to late-stage HIV or Aids, the name for a collection of illnesses caused by the virus.

Hepatitis B and Hepatitis C cause inflammation of the liver and come from viral infections, according to the NHS. Both can be contracted through blood-to-blood contact with an infected person.

Opt-out testing for blood-borne viruses has been seen by health officials and ministers as a resounding success for the NHS, which has not yet released the names of the latest hospitals added to the scheme.

The BBC understands health leaders hope to expand opt-out testing to detect more diseases in the future.

Sean Connaughton, from London, told the BBC he would "have been dead" had it not been for the opt-out testing.

He is one of the hundreds of people to discover they were living with HIV after being diagnosed through the scheme.

He attended hospital in October 2023 after suffering from seizures and losing 20kg (44lbs) through repeated sickness.

"Unless I had gone to A&E and I had done that test, my diagnosis would never have been known," Mr Connaughton said.

Without a diagnosis, doctors told him "some of the other infections I had would have gone into my spine and into my brain", he told the BBC.

"Two days prior to being admitted, I'd had a seizure in the bathroom and smashed my head into the basin and passed out, so the body was already breaking at that point.

"I wouldn't have survived, I don't think, another couple of weeks, if I hadn't been tested."

Richard Angell, the chief executive of sexual health charity the Terrence Higgins Trust, said opt-out testing was a "win-win for everyone".

"The benefit of opt-out testing is that you can get a test to people that would otherwise never come forward for a HIV test," Mr Angell said.

He added "that means a transformation for the individual" who can begin to take medication, which "means the virus is no longer attacking their immune system and they can't pass it on if they're having sex or having a baby".

Mr Angell said early testing also makes "good money sense for the NHS" as it allows early treatment, which stops HIV progressing, preventing severe illness, emergency visits and more costly treatments.

The testing forms part of a pledge by Sir Keir Starmer to eliminate new transmissions of HIV by 2030.

Earlier this week, Sir Keir became the first sitting prime minister to publicly take an HIV test.

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