New modelling presented at EASL Congress 2026 suggests that emergency department opt-out testing for HIV, hepatitis B (HBV) and hepatitis C (HCV) in Poland could improve diagnosis and linkage to care, while remaining cost-effective over a lifetime horizon.
The study assessed the clinical and economic impact of introducing emergency department blood-borne virus (BBV) opt-out testing in Poland, compared with current standard of care, in which systematic emergency department testing is not implemented.
Poland continues to face challenges in meeting viral hepatitis and HIV elimination targets, with diagnosis rates for HIV, HBV and HCV remaining below global ambitions. Delayed diagnosis and gaps in linkage to care can also contribute to poorer health outcomes and ongoing transmission.
Emergency departments may offer an important opportunity to reach individuals who are less routinely engaged with traditional healthcare services. European guidance also increasingly supports integrated BBV testing approaches, but implementation remains limited in many healthcare settings.
Using a decision tree and lifetime Markov modelling approach, the analysis assessed additional diagnoses, linkage to care outcomes, quality-adjusted life years (QALYs), and long-term healthcare costs, drawing on Poland-specific epidemiological and healthcare data.
For every 10,000 people tested, emergency department opt-out testing was estimated to identify 128 additional blood-borne virus infections and link 95 people to care. The largest number of new diagnoses was estimated for HBV, followed by HIV and HCV.
Combined testing for BBV was cost-effective over a lifetime horizon, with costs per QALY gained remaining below the Polish willingness-to-pay threshold, suggesting the approach could be robust across different epidemiological settings.
Together, the findings point to ED opt-out testing as a way to improve earlier diagnosis and linkage to care for BBVs in Poland. They also underline the need for strong post-diagnosis pathways to ensure screening programmes deliver long-term public health benefit.
The findings of this research were presented at the European Association for the Study of the Liver (EASL) in Barcelona, Spain, in May 2026. Poster link.
Citation: Flisiak R, Kowalska J, Fal A, et al. Advancing elimination targets for viral hepatitis and HIV in Poland: estimating the cost-effectiveness of emergency department opt-out testing for blood-borne viruses. Poster presentation at EASL Congress 2026; 27-30 May 2026, Barcelona, Spain.
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