In a pilot scheme part funded by the Elton John AIDS Foundation, a leading London hospital says it has identified 32 people who are HIV positive. All of them had come for emergency treatment and not for a sexual-health check-up.
Twelve months ago, King’s College Hospital in Southwark began routinely testing every blood sample donated by patients coming to its emergency departments.
Today, the hospital trust announced that from 24,037 patients tested, 32 were positive for HIV.
Of these, around half were, ‘considered late diagnoses and would have been at high risk of developing AIDS … had they not have been started on antiretroviral medication.’
A spokesperson for King’s College Hospital told GSN that patients do have the opportunity to opt out of the scheme.
‘There are posters and leaflets all around our A&E explaining the opt-out service we provide, so we test with the patient’s knowledge. If any patients choose to opt out they can do so by letting a member of staff know.’
The scheme will now become routine practice at the hospital going forward.
Although testing for HIV in emergency department blood samples is not routine across all hospitals, it is something that an increasing number of NHS Trusts are exploring.
Guy’s and St Thomas’ Hospital, also in the borough of Southwark, launched a similar initiative in July 2015. A spokesperson told GSN that in the first two years of the initiative (up to June 2017), it had led to the diagnosis of 122 cases of HIV.
‘People develop complications because they don’t know they have the infection’
Dr Killian Quinn, Consultant in Sexual Health at King’s College Hospital said in a statement, ‘When HIV is detected and treated early, antiretroviral medication can be so effective the virus can become undetectable in some patients, meaning they can no longer pass the virus on to others.
‘With the sophisticated medicines now available, HIV is no longer a death sentence but a treatable condition. One of the most common reasons people develop complications is because they don’t know they have the infection. Our universal testing scheme is a big step forward in addressing this issue.’
King’s College patient: ‘Getting diagnosed early has given me a second chance’
One man to benefit from the scheme is a lawyer in his late 20s. Through a statement issued via the King’s College Hospital, the man – who wished to remain anonymous – said: ‘I began to feel unwell last autumn but work had been very busy and I’d been putting in long hours so I put it down to exhaustion.
‘Then, in February, I had what I thought was a bad case of flu. I saw my GP who suggested I go to King’s. They did a blood test in the Emergency Department and the results came back a few days later.
‘Initially, I was in shock but the sexual health team at King’s have been incredibly supportive and talked me through everything. They carried out further blood tests and I was started on a treatment plan two weeks later.
‘They also signposted me to sources of advice and support, which I could access when I felt ready. Nine months on and I’m feeling much better, and thanks to the antiviral medication my HIV infection is at an undetectable level.
‘Getting diagnosed early has given me a second chance, and helped me avoid a situation worse that being infected with HIV – being responsible for passing it onto someone else.’
London has the highest rate of HIV cases of any city in the UK, partly because of its high population for gay men. Around one in eight gay men are estimated to be HIV positive in the UK capital, but many remain unaware of their status.
However, the number of new diagnoses in the UK has fallen over the last 12 months for the first time since the virus first appeared in the 1980s. This has been put down to more people using PrEP (Pre-Exposure Prophylaxis), more people being regularly tested, and getting HIV positive people quickly on to medication.
‘We must do more to break down the stigma associated with the virus’
The King’s College Hospital scheme has been welcomed by sexual health campaigners.
‘It’s estimated that about 13% of gay and bisexual men who are living with HIV don’t know that they have the virus,’ said Ian Howley, chief executive of gay men’s health charity, GMFA.
‘Anything that helps us capture these diagnosis early will help towards stopping the spread of the virus. Also any person diagnosed with HIV will be put on treatment straight away meaning that once the treatment becomes successful that person will become HIV-undetectable and won’t pass on the virus to anyone.
‘However, I can see why some people might opt out of this. Unfortunately because of the stigma associated with HIV many still would rather not know.
‘We must do more to break down the stigma associated with the virus. People living with HIV lead healthy normal lives. Testing early and frequently will help us stop HIV.’