Clinicians are now recommended to screen all patients aged 15 to 65, and other teens or older adults who are at an elevated risk for HIV infection, according to new guidelines released today.
The guidelines were part of the final recommendation statement on screening for HIV by the U.S. Preventive Services Task Force and were published online Monday, April 30th in the Annals of Internal Medicine.
Additionally, they recommend that all pregnant women, even those in labor whose HIV status is unknown, be tested for HIV.
Task Force member Douglas K. Owens, M.D., M.S., said:
“While the best way to reduce HIV-related disease and death is to avoid getting infected, screening is also extremely important. Nearly a quarter of people with HIV don’t know that they have it, and they’re missing out on a chance to take control of their disease. Universal screening will help identify more people with HIV, allowing them to start combined antiretroviral therapy earlier and live healthier and longer lives.”
The guidelines were released following a number of publicized cases in which early treatment along with a combination of strong antiretroviral drugs has significantly improved patient survival rates.
For example, just last month, a study showed that 14 HIV-infected adults appeared to be “functionally cured” – or carrying a small, hardly detectable amount of HIV in their bodies; they do not experience symptoms, even without treatment. Those patients had received antiretroviral drugs within 10 weeks of becoming infected.
Additionally, a baby was cured of HIV after being given antiretroviral therapy 30 minutes after birth. Treating an HIV-positive newborn infant this soon after birth is highly uncommon.
HIV is a retrovirus that harms the cells that protect the body from disease – it can take years for symptoms to develop. The virus is passed through blood and semen.
High-risk groups include:
- intravenous drug users
- men who have sex with men
- people who have unprotected vaginal or anal intercourse
- those who have a partner who is HIV-positive, bisexual, an injection drug user, or exchanges sex for money or drugs
Until this point, the Task Force has only recommended HIV screening for people in these risk groups and for pregnant women. However, after an analysis of more data, evidence showed that almost 25% of people who are infected with HIV in the U.S. do not know they are infected. The task force believes that widespread early detection would “result in substantial public health benefits”.
The newest recommendations suggest everyone 15 to 65 get a one-time screening. Women should also be tested during every pregnancy.
Task Force chair Virginia Moyer, M.D., M.P.H., explained:
“HIV is a critical public health problem and, despite recent medical advances, still a devastating diagnosis for the 50,000 people in the United States who contract HIV each year. In order to help reduce the suffering of those with HIV and their loved ones, we must continue finding better ways to prevent and treat this disease.”
The Task Force also suggests, in accordance with the CDC’s recommendations, that the testing be voluntary and patients should be informed orally or in writing that the HIV testing has been conducted, unless they opt-out of screening.
Written by Kelly Fitzgerald