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UK projects shows emergency department testing can uncover undiagnosed HIV

The United Kingdom has been trialing a new approach to reaching people with undiagnosed HIV, by adding HIV testing to standard blood tests in emergency departments.

Usually a HIV test is something patients must ask for, but doctors have flipped the script and now test for HIV and other blood-borne virus unless people opt out.

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The results are showing the the move can help to reach people who have the virus and are late in getting diagnosed.

Late diagnose patients, people who have potentially been living with virus for years, have been identified as one of the harder groups of people to reach through education campaigns.

Additionally these people are at greater risk of passing the virus on to others, as once people begin treatment they can usually report having a non-detectable viral load within a few months. Once a person has an undetectable level of the virus they are unable to transmit HIV to other people.

A new report from two hospitals in the Leeds area has shown that over a two year period they tested 45,000 blood samples, revealing 14 cases of previously unknown HIV, alongside 80 cases of hepatitis B and 47 cases of hepatitis C.

Dr Emma Page, a consultant in virology at Leeds Teaching Hospitals NHS Trust, told the Yorkshire Post that tests could save lives.

“Anyone can get a blood borne virus and you may feel perfectly well for many years – you would not know unless you have a test,” she said.

“There is now life-saving treatment that people can take to control or cure the infection. It really is better to know your status.” she said.

Last year Dr Daniel Vujcich from WAAC said the approach might also be valuable in Australia.

“They’ve achieved really great outcomes as a result of making HIV testing an opt out test whenever someone goes to an emergency room and gets tested for anything. It’s been phenomenal in terms of capturing people who would not have been tested and have not been tested for many years, and are presenting with late and advanced stage diagnoses.

Dr Vujcich cited the UK experiment as the kind of bold move he’d like to see trialed in Australia, and he hoped a national conversation about the proposal would be embraced.

“There’s a question about making sure that the hospitals that you choose have sufficient HIV prevalence for it to be a cost effective option. There are definitely hospitals in Australia where that is the case.” he noted.

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