Kim Jong un
2013-05-01 03:32:32 UTC
Federal panel says everyone 15 to 65 should have HIV test
The U.S. Preventive Services Task Force finalizes its guideline that
everyone 15 to 65 be screened for the virus that causes AIDS
By Monte Morin, Los Angeles Times
April 29, 2013, 4:09 p.m.
Citing recent evidence that HIV infections are best managed when
treated early, an influential panel of medical experts has finalized
its recommendation that all people ages 15 to 65 be screened for the
virus that causes AIDS.
The recommendation from the U.S. Preventive Services Task Force seeks
to address one of the key challenges in the fight against HIV/AIDS:
The window during which patients respond best to treatment is also the
time when symptoms of the disease are least noticeable.
"HIV is a critical public health problem, and there are still 50,000
new infections per year," said Dr. Doug Owens, a task force member and
professor of medicine at Stanford University. "There's very good
evidence that treatment is effective when given earlier, at a time
when people are often asymptomatic. So the only way they would know
that they had HIV, or that they needed treatment, is to be screened."
The guideline is being released after a number of well-publicized
cases in which early treatment with a combination of powerful
antiretroviral drugs has greatly improved patient survival rates. In
one of those instances, doctors reported in March that an infant in
Mississippi who began aggressive drug treatment immediately after
birth had been "functionally cured" of HIV.
The new statement, published online Monday on the task force's website
and by the Annals of Internal Medicine, is a departure from the more
cautious recommendation the task force made in 2005. It brings the
advisory panel into alignment with other prominent medical groups that
recommend routine, voluntary HIV screening of adolescents and adults.
Those organizations include the U.S. Centers for Disease Control and
Prevention, the American College of Physicians, the Infectious Disease
Society of America and the American Congress of Obstetricians and
Gynecologists.
"We hope that now, with all groups recommending really similar things,
the message will get out," Owens said.
HIV is a retrovirus that attacks the cells that work to protect the
body from disease, and it can take years or even decades for serious
symptoms to appear. The virus is most commonly transmitted through
blood and semen; intravenous drug users and men who have sex with men
are considered to be at highest risk of infection. Other risk groups
include people who have unprotected vaginal or anal intercourse and
those who have sex with a partner who is either HIV-positive,
bisexual, an injection drug user or who exchanges sex for drugs or
money.
Until now, the task force had recommended HIV screening only for
people in these risk groups and for pregnant women. When formulating
their earlier guidance, task force members expressed concern that
widespread testing might result in false-positive results or cause
depression and social stigma among those who learned they were
infected. Panel members also said that long-term treatment could
result in harmful side effects, such as cardiovascular disease.
Based on a review of more recent data — including evidence that as
many as 25% of people who carry HIV in the U.S. have no idea they are
infected — task force members concluded that early detection would
"result in substantial public health benefits" that outweighed any
risks of widespread screening.
The task force "found convincing evidence that conventional and rapid
HIV antibody tests are highly accurate in diagnosing HIV infection,"
wrote Dr. Virginia Moyer, a pediatrician and task force chairwoman.
"Although long-term use of certain antiretroviral drugs may be
associated with increased risk for cardiovascular and other adverse
events, the magnitude of risk seems to be small."
This latest recommendation urges that everyone 15 to 65 undergo a one-
time screening. Individuals in risk groups who are older or younger
should undergo screening as well.
Also, women should be tested during each pregnancy, the task force
says.
The task force recommended annual screenings — at the very least — for
people in known risk groups.
"The question is, 'Do you have ongoing risk, like new sexual
partners?'" Owens said. "If you do, then it makes sense to screen
periodically."
Patients should also be offered the opportunity to ask questions and
to decline testing, the panel wrote.
Since the first cases of AIDS were reported in 1981, more than 1.1
million people have been diagnosed and more than 595,000 have died
from the condition.
In an editorial that accompanied the recommendation, UC San Francisco
AIDS experts Dr. Moupali Das and Dr. Paul Volberding wrote that the
new task force guidelines were of "critical significance" and that
diagnosing those who have HIV but don't realize it would have a far-
reaching effect.
"Ending the epidemic will be very difficult, and only effective
screening can make it remotely possible," they wrote. "Informing all
infected persons of their status may well reduce ongoing transmission
risk behavior in [and] of itself, and if antiretroviral therapy is
also accepted and successful, further spread will be substantially
reduced and perhaps even eliminated."
The U.S. Preventive Services Task Force finalizes its guideline that
everyone 15 to 65 be screened for the virus that causes AIDS
By Monte Morin, Los Angeles Times
April 29, 2013, 4:09 p.m.
Citing recent evidence that HIV infections are best managed when
treated early, an influential panel of medical experts has finalized
its recommendation that all people ages 15 to 65 be screened for the
virus that causes AIDS.
The recommendation from the U.S. Preventive Services Task Force seeks
to address one of the key challenges in the fight against HIV/AIDS:
The window during which patients respond best to treatment is also the
time when symptoms of the disease are least noticeable.
"HIV is a critical public health problem, and there are still 50,000
new infections per year," said Dr. Doug Owens, a task force member and
professor of medicine at Stanford University. "There's very good
evidence that treatment is effective when given earlier, at a time
when people are often asymptomatic. So the only way they would know
that they had HIV, or that they needed treatment, is to be screened."
The guideline is being released after a number of well-publicized
cases in which early treatment with a combination of powerful
antiretroviral drugs has greatly improved patient survival rates. In
one of those instances, doctors reported in March that an infant in
Mississippi who began aggressive drug treatment immediately after
birth had been "functionally cured" of HIV.
The new statement, published online Monday on the task force's website
and by the Annals of Internal Medicine, is a departure from the more
cautious recommendation the task force made in 2005. It brings the
advisory panel into alignment with other prominent medical groups that
recommend routine, voluntary HIV screening of adolescents and adults.
Those organizations include the U.S. Centers for Disease Control and
Prevention, the American College of Physicians, the Infectious Disease
Society of America and the American Congress of Obstetricians and
Gynecologists.
"We hope that now, with all groups recommending really similar things,
the message will get out," Owens said.
HIV is a retrovirus that attacks the cells that work to protect the
body from disease, and it can take years or even decades for serious
symptoms to appear. The virus is most commonly transmitted through
blood and semen; intravenous drug users and men who have sex with men
are considered to be at highest risk of infection. Other risk groups
include people who have unprotected vaginal or anal intercourse and
those who have sex with a partner who is either HIV-positive,
bisexual, an injection drug user or who exchanges sex for drugs or
money.
Until now, the task force had recommended HIV screening only for
people in these risk groups and for pregnant women. When formulating
their earlier guidance, task force members expressed concern that
widespread testing might result in false-positive results or cause
depression and social stigma among those who learned they were
infected. Panel members also said that long-term treatment could
result in harmful side effects, such as cardiovascular disease.
Based on a review of more recent data — including evidence that as
many as 25% of people who carry HIV in the U.S. have no idea they are
infected — task force members concluded that early detection would
"result in substantial public health benefits" that outweighed any
risks of widespread screening.
The task force "found convincing evidence that conventional and rapid
HIV antibody tests are highly accurate in diagnosing HIV infection,"
wrote Dr. Virginia Moyer, a pediatrician and task force chairwoman.
"Although long-term use of certain antiretroviral drugs may be
associated with increased risk for cardiovascular and other adverse
events, the magnitude of risk seems to be small."
This latest recommendation urges that everyone 15 to 65 undergo a one-
time screening. Individuals in risk groups who are older or younger
should undergo screening as well.
Also, women should be tested during each pregnancy, the task force
says.
The task force recommended annual screenings — at the very least — for
people in known risk groups.
"The question is, 'Do you have ongoing risk, like new sexual
partners?'" Owens said. "If you do, then it makes sense to screen
periodically."
Patients should also be offered the opportunity to ask questions and
to decline testing, the panel wrote.
Since the first cases of AIDS were reported in 1981, more than 1.1
million people have been diagnosed and more than 595,000 have died
from the condition.
In an editorial that accompanied the recommendation, UC San Francisco
AIDS experts Dr. Moupali Das and Dr. Paul Volberding wrote that the
new task force guidelines were of "critical significance" and that
diagnosing those who have HIV but don't realize it would have a far-
reaching effect.
"Ending the epidemic will be very difficult, and only effective
screening can make it remotely possible," they wrote. "Informing all
infected persons of their status may well reduce ongoing transmission
risk behavior in [and] of itself, and if antiretroviral therapy is
also accepted and successful, further spread will be substantially
reduced and perhaps even eliminated."