Life-saving testing for HIV, hepatitis B and C rolled out in A&E

Patients aged 16 and over who receive routine blood tests when they attend the emergency department (A&E) at St Thomas’ Hospital will be tested for HIV and hepatitis B and C, unless they choose to opt out.

The emergency department is one of the busiest in the country with more than 61,000 blood tests carried out each year – around 5,100 per month. The combined blood borne virus testing will lead to earlier diagnosis and treatment for people who may be unaware that they have one of the viruses.

Since July 2015, all patients over the age of 16 having a blood test in the emergency department at St Thomas’ have been tested for HIV, unless they chose to opt out. This has resulted in more than 2,300 positive results.

Dr Bo Wang, a consultant gastroenterologist and hepatologist at Guy’s and St Thomas’, said: “Southwark and Lambeth have some of the highest rates of HIV and hepatitis B and C in England. Testing is needed because infection often does not have any symptoms, so people wouldn't necessarily know unless they have a specific blood test. 

“Chronic hepatitis B and C infection are major causes of liver cirrhosis and liver cancer, but with early diagnosis and management these complications can be prevented.”

According to the Office for Health Improvement and Disparities, Lambeth has the highest level of HIV infection in England with 12.67 per 1,000 adults aged between 15 and 59 diagnosed with the virus, while Southwark has the second highest rate with 11.23 per 1,000. The national average for England is 2.34 per 1,000.

Dr Laura Hunter, a consultant in emergency medicine and clinical toxicology at Guy’s and St Thomas’, said: “Our Trust is proud to have been providing HIV testing in our emergency department since 2015 making it a standard part of the care our patients receive. By normalising testing we have helped to reduce stigma associated with HIV.

“Testing in our emergency department has been hugely effective in allowing patients, who may not have been aware of their infection, to access successful and safe HIV treatments. This is allowing them to live long and healthy lives. We also know that a patient who is successfully on treatment for HIV, with an undetectable viral load, cannot transmit the virus to other people. This is hugely important for the health of our local communities, but also key to attaining the UK Action Plan to achieve zero HIV transmissions in England by 2030.”

All patients who have a blood test in the emergency department will be given an information leaflet to explain why routine testing for HIV and hepatitis B and C has been introduced. Those who are newly diagnosed with a virus will be contacted and asked to attend the hospital to confirm their initial diagnosis and to plan treatment.