Europe is not doing enough to detect HIV, hepatitis, health authorities warn

Many European countries are falling behind on efforts to detect life-threatening diseases such as HIV and hepatitis, a new analysis has found.

In 2018, the European Centre for Disease Prevention and Control (ECDC) issued new guidance on testing for HIV and hepatitis B and C in an effort to get people into treatment more quickly and prevent them from infecting others, given that it can take years for symptoms to emerge.

But in many countries, testing policies are “out of date” and “not aligned with ECDC recommendations,” according to the agency’s report, which included the 27 EU member states as well as Iceland, Liechtenstein, and Norway.

More than 650,000 people have been diagnosed with HIV across the region, including nearly 25,000 in 2023. An estimated 5.4 million people have chronic hepatitis B or C.

In 26 countries with data, an estimated 92 per cent of people with HIV had actually been diagnosed – but overall, more than half of people with HIV are diagnosed late, the report found.

These patients live an estimated three to five years without knowing they have HIV, putting them at “increased risk of morbidity, mortality, worse treatment outcomes, and transmitting the virus to others,” the ECDC said.

Late diagnosis is also common for hepatitis B and C patients. Many people only realise they are infected when they begin to suffer from life-threatening complications such as liver cancer and liver failure caused by cirrhosis.

According to global health targets, 95 per cent of people with HIV and 60 per cent of those with chronic hepatitis B and C should be aware of their status so they can access timely treatment.

The ECDC said this could be achievable for HIV in the coming years – but that it “will be more challenging” to reach the target for hepatitis B and C.

Notably, HIV testing is free in 24 countries, while hepatitis testing is free in 17. Just 22 countries say they have a national plan to respond to hepatitis.

More than half of countries have not updated their HIV or hepatitis testing recommendations since 2018.

The ECDC recommended that countries boost access to testing, particularly for groups at higher risk of infection, including men who have sex with men, people who inject drugs, transgender people, and those in prison.

HIV and hepatitis B are commonly spread through an infected person’s body fluid, for example during sex. Hepatitis C is a bloodborne virus that can spread in unsafe medical settings or when drug users share needles.

The new report is not the first time health authorities have warned that European countries are off track to meet these goals.

Earlier this year, they said Europe would miss its targets to fight HIV, hepatitis, other sexually transmitted infections (STIs), and tuberculosis (TB) without significant investments in public health.