HIV Testing: Support for Routine Screening

Main Article Content

Brett Edwards, BSc. Pharm
Stephen Vaughan MD DTMH

hiv screening, hiv testing, hiv detection, hiv infection, human immunodeficiency virus, hiv testing support, routine hiv screening, chronic disease screening, immunodeficiency virus hiv

Abstract

This article discusses the recent evolution of human immunodeficiency virus (HIV) screening recommendations with significantly expanded role for routine HIV testing. After the Centre for Disease Control (CDC) released recommendations for routine screening in 2006, it was anticipated that the United States Preventive Services Task Force (USPSTF), a national body charged with providing evidence-based recommendations for preventive services, would follow shortly. However, they refrained, citing a lack of evidence at the time to make such a recommendation, and maintained a recommendation for risk-based screening. Following an analysis of recent literature, in 2013 the USPSTF finally made a recommendation for routine HIV screening on the grounds of new evidence. The recommendations are based on the clinical benefit, the failures of risk-based screening, cost-effectiveness data with reduction in HIV related morbidity/mortality, and lower rates of transmission. This article highlights some of the literature that accounted for the change in recommendations and provides a basic review of HIV testing techniques available to the internists and the recommendations for routine screening of patients.
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References

1. Kang Cornett J, Kirn TJ. Laboratory diagnosis of HIV in adults: a review of

current methods. Clin Infect Dis 2013;57:712–8.

2. Moyer VA, U.S. Preventive Services Task Force. Screening for HIV: U.S. preventive services task force recommendation statement. Ann Intern Med 2013;159:51–60.

3. Niel Constantine. HIV InSite Knowledge Base: HIV Antibody Assays. Available from: http://hivinsite.ucsf.edu/InSite?page=KB. Accessed Jan 25, 2014.

4. Branson BM, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR: Recommendations and Reports 2006;55(RR–14):1–17.

5. United States Preventive Services Task Force. Screening for HIV: Recommendation Statement [internet]. 2005 [updated 2007 April 2]. Available from: http://www.uspreventiveservicestaskforce.org/uspstf05/hiv/ hivrs.htm. Accessed Jan 21, 2014.

6. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiviral therapy. N Engl J Med 2011;365:493–505.

7. Long EF, Brandeau ML, Owens DK. The cost-effectiveness and population outcomes of expanded HIV screening and antiretroviral treatment in the United States. Ann Intern Med 2010;153:778–89.

8. Sanders GD, Bayoumi AM, Sundaram V, et al. Cost-effectiveness of screening for HIV in the era of highly active antiretroviral therapy. N Engl J Med 2005;352:570–85.

9. Centre for Disease Control. Vital signs: HIV testing and diagnosis among adults – United States, 2001-2009. MMWR 1010;59:1550–5.

10. Emery S, Neuhaus JA, Phillips AN, et al. Major clinical outctherapy (ART)- naïve participants and in those not receiving ART at baseline in the SMART study. J Infect Dis 2008;197:1133–44.