ArticleLiver international : official journal of the International Association for the Study of the Liver2026
Emergency Department Opt-Out Testing for Hepatitis B: A Two-Year UK Multicentre Evaluation of Outcomes Across Seven Sites.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Article
- Emergency Department Opt-Out Testing for Hepatitis B: A Two-Year UK Multicentre Evaluation of Outcomes Across Seven Sites.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
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Authors and funding
16 authors.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsAn estimated 270 000 people in the UK live with hepatitis B infection, the leading global cause of liver cancer. In 2022, opt-out hepatitis B testing was introduced in emergency departments (ED) in London. We conducted a 2-year multicentre evaluation of this programme across seven sites.
methodsAdults testing positive for hepatitis B surface antigen (HBsAg) through ED opt-out testing (n = 983) were compared with those referred via non-ED pathways (n = 416) over at least 12 months in the same regions with a six-month follow-up period. Demographics, clinical characteristics and factors influencing time to assessment were analysed.
resultsED testing led to a 107% increase in HBV assessments. Of 983 HBsAg-positive individuals, 90.2% (887/983) were contactable and 97% (660/679) of those requiring assessment were linked to care. 35% were aware of their diagnosis but not under specialist care. Among ED-diagnosed individuals, 16.37% had significant fibrosis and 20.45% had viral loads > 2000 IU/mL. ED referrals were older (mean age 51 vs. 47 years, p < 0.001) and had lower viral loads (mean log10 HBV DNA 2.08 vs. 2.78, p < 0.001). Mean time to assessment in the ED group was 90 days.
conclusionsED opt-out testing has doubled new assessments of hepatitis B cases, identifying individuals who would benefit from surveillance and/or treatment. Linkage-to-care rates were very high, though time to assessment was prolonged by service factors. A significant proportion were aware of their diagnosis but lost to care, underscoring the need for services which can maintain engagement.
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