More than 100,000 people in Britain are predicted to be living with HIV by the end of this year, according to an official report that warns that the virus is on the rise again in the UK.
While there is a continuing drop in new cases among people who have acquired HIV abroad, the numbers infected within the UK are on the rise, the Health Protection Agency says in the report on Tuesday. New diagnoses of HIV in men who have sex with men have hit a record high.
New infections of the virus, which eventually causes Aids if not kept in check by drugs, had been falling in the UK but that trend seems to have levelled off, according to the agency’s annual HIV report. At the end of 2010, there were an estimated 91,500 people with HIV in the UK, up from 86,500 the previous year. The figure includes estimates for those who have not had a test and do not know they are infected – thought to be around a quarter of the total.
In 2010, according to the HPA’s data, there were 3,000 new infections among men who have sex with men, 81% of which occurred in the UK. Most of the men were white (83%) and two-thirds (67%) were born in the UK. Some had been HIV-positive for years without knowing, but a third of those who were recently infected were under 35. The figures suggest that one in 20 gay men are living with HIV, the ratio rising to one in 12 in London.
When the epidemic began 30 years ago, people with HIV swiftly became sick, developed Aids and died of infections such as pneumonia that their bodies could not fight off. Today, combinations of antiretroviral drugs keep people alive and healthy and can give them a normal lifespan as long as they stay on the medication. That means the number living with the virus continues to rise.
Of the 91,500 people estimated to have HIV in the UK, just over 40,000 of the total are men who have sex with men. Around 2,300 are injecting drug users. Of the 47,000 infected through heterosexual sex, around 19,300 were African-born women and 9,900 African-born men. The prevalence rate in the black African community is one in 32 among men and one in 15 women.
Half of those who are diagnosed with HIV have gone to a doctor years after infection, at the point when they have fallen ill. Those people have a much worse prognosis: they are 10 times more likely to die within a year of diagnosis than people who were diagnosed earlier.
In 2010, 680 HIV-positive people died, 510 of them men. Two-thirds were people who had been diagnosed late. Most died within a year of being tested.
People who have not been diagnosed risk infecting others. The HPA says that there is a need to introduce routine HIV tests around the country beyond the traditional confines of sexually transmitted infection and antenatal clinics.
There have been pilot projects in the last two years in London, Brighton, Leicester and Sheffield. Testing was successfully introduced in two general practices, the acute care units of three hospitals and two community settings without opposition from staff or patients.
Greater efforts to test people and prevent infection would save the NHS money, because treating people is expensive, the HPA says. Because HIV has become a chronic, manageable condition instead of a fatal illness, the costs of providing specialist treatment and care are substantial and accelerating.
“It is difficult to calculate the true expenditure on HIV in the UK. However, of the £1.9bn spent by the Department of Health on infectious diseases in England in 2009-10, an estimated 40% was allocated to the treatment of HIV and Aids. This total does not include the costs of psychosocial care or HIV testing, so in fact the total amount spent on HIV treatment is much higher,” the report says.
The amount spent on prevention, the HPA adds, was £2.9m, just 1% of the overall HIV budget in 2010. The report says: “Investing in prevention should be a priority because of its potential for cost savings. We estimate that each infection prevented would save between £280,000 and £360,000 in lifetime treatment costs.
“If the 3,640 UK-acquired HIV diagnoses made in 2010 had been prevented, between £1bn and £1.3bn lifetime treatment and clinical care costs would have been saved.”