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HIV tests could become routine in US

20th August 2012

Health experts in the United States are deliberating whether to include HIV testing in standard health checks alongside cholesterol testing and other practices.

hiv

A group of clinicians and scientists will publish its opinion on the matter by the end of 2012, with some sources saying routine HIV testing is likely to be recommended.

The government-backed US Preventive Services Task Force's last recommendation on HIV testing in 2005 was that whether or not to test should be left to the discretion of doctors.

According to Michael Kharfen, chief of community outreach for the Washington DC Department of Health, a positive recommendation would amount to a major change in HIV policy.

Kharfen, who worked in HIV care when AIDS came to the attention of the medical profession in the 1980s, said that such a policy recommendation would move US healthcare away from a system that puts people with HIV in a separate compartment from people with other health problems.

He said such a move would be a huge step forward, but would entail a profound change in current medical care culture.

When Kharfen first encountered the disease in New York, an HIV-positive test result was effectively a death sentence.

However, the epidemic is still very much present in the United States, with an estimated 1.2 million people living with the virus, 20% of whom are unaware that they have been infected, according to the US Centers for Disease Control and Prevention (CDC).

The country records around 60,000 new cases of HIV annually, and health bodies including CDC have already called for HIV screening to be a routine part of healthcare procedures.

Under the US health reform law of 2010, health insurance providers are required to cover preventive services endorsed by the Preventive Services Task Force.

Population-wide testing could also pave the way for earlier intervention and treatment for people living with HIV, an approach which was shown in a recent study to slash the risk of transmission to uninfected partners by 96%.

Recently developed HIV treatment regimes can extend the lives of patients for decades, but are also a powerful preventive measure that cuts down on the spread of the virus.

According to Lisa Fitzpatrick, director of the United Medical Centre HIV clinic in Washington, all healthcare providers should seek out cases of HIV because the virus is no longer found mostly in high-risk groups like men who have sex with men, but is present in the broader population.

CDC recommended, along with the American College of Physicians and the HIV Medicine Association, in 2006 that everyone should get an HIV test at least once in their life.

Executive Director Kevin Fenton said his focus was more about the public health dimensions of HIV, while the task force was more likely to be looking at clinical care and preventive medicine.

To make its recommendation, the task force will have to be convinced that the potential benefits of an HIV test outweigh the potential harm. Previous evaluations concluded that routine testing would have little effect on preventing new infections.

But task-force co-chair Michael LeFevre said that new scientific evidence showing the effect of early intervention on transmission rates would be factored into the panel's conclusion.


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