European guidelines recommend routine testing in healthcare settings in areas with a high prevalence of blood borne viruses (HIV, HBV, and HCV). In the UK, emergency departments (EDs) in high-prevalence areas have successfully implemented an opt-out testing strategy, which has proven effective in identifying individuals living with undiagnosed blood-borne viruses (BBVs), particularly those who do not engage with traditional testing services. This approach also facilitates the re-engagement of previously diagnosed individuals who have disengaged from care. However, there remains a lack of comprehensive guidance for the implementation of BBV testing in EDs.

The aim of the current EuroTEST project is to develop a practical guidance document to support the implementation of BBV testing in emergency departments (EDs) in high prevalence settings in Europe drawing on pilot experiences and expert knowledge. The guidance will serve as a toolkit outlining key considerations for implementations and include case studies presenting different ways of implementation.  Target audience will be politicians, clinicians and public health physicians.

In 2025 EuroTEST established an advisory group to supervise the development process and the content of the practical implementation guidance. The advisory group comprise European organizations like ECDC, IUSTI and EASL, infectious disease specialists, emergency medicine specialists, as well as virologist, epidemiologist and patient organizations.

Guidance recommendations will be based on best practices from European countries collected through a rapid review of the existing literature and on expert advice from the project advisory group.

A draft of the guidance recommendations was presented at a special session the EACS conference 2025 in Paris in order to receive input and feedback from session participants. The draft guidance will be put online on the EuroTEST website for a public consultation period where key stakeholders will be invited to provide input. Feedback from the EACS conference and the public consultation will be incorporated into the final guidance document for BBV testing implementation in emergency department settings.
The guidance will furthermore include interviews with key stakeholders and a repository of templates of patient information and training materials for countries to use when implementing BBV screening in local EDs.