Medical panel says all Americans ages 15 to 65 should get HIV test

HIV test, generic AP

All Americans between the ages of 15 and 65 should get tested for HIV, a U.S. panel of medical experts said Tuesday.

The U.S. Preventive Services Task Force recommended in its new guidance that all doctors should screen patients between these ages for HIV, including pregnant women and those who go to the doctor in labor. Adolescents and children under 15 as well as adults over 65 should also get screened if they are considered high-risk, the panel added.

"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," said Task Force chair Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine in Houston, said in a statement.

The Task Force is made up of an independent group of physicians that advise the government on medical screening and treatment guidelines. Their recommendations were published April 30 in the Annals of Internal Medicine.

About 1.2 million Americans are living with human immunodeficiency virus (HIV), an incurable disease that weakens in the immune system, eventually progressing into acquired immunodeficiency syndrome (AIDS) if left untreated.

The most common way the disease is transmitted is through anal or vaginal sexual intercourse or by sharing drug injection equipment with infected individuals.

People are tested for the virus commonly through a comprehensive blood test, or through rapid HIV testing that may use blood or saliva to provide a result in five to 40 minutes.

The panel reviewed studies on HIV testing and any potential risks and benefits of detecting the virus early, and found "convincing evidence" that identifying and treating HIV early can significantly reduce risk for progression to AIDS, AIDS-related complications or death.

The panel added that people who test positive with a rapid test should get a standard blood test to confirm results.

Panelists also found evidence that diagnosing and treating an HIV-positive pregnant women could dramatically reduce the odds the virus is passed to their children.

The task force did find some harms associated with HIV screening, in that antiretroviral drugs often used for treatment can carry short-term side effects. Also, long-term use of antiretroviral drugs might increase risk slightly for heart problems and other illness. But, the authors concluded, "The overall harms of screening for and treatment of HIV infection in adolescents, adults, and pregnant women are small."

HIV screening guidelines released by the group in 2005 recommended testing for only high-risk individuals.

How often should people get an HIV test?

The task force said the evidence it reviewed was insufficient to recommended an optimum schedule, but noted it would be reasonable to have a one-time screening of adolescent and adult patients to identify persons who are already HIV-positive, with repeated screening of those who are known to be at higher risk, including those who are actively engaged in risky behaviors, and those who live or receive medical care in areas with high HIV rates.

The Centers for Disease Control and Prevention and other medical societies offer similar recommendations for HIV screening, the panel pointed out.

The new guidelines would likely trigger coverage for the tests as a preventive service under President Barack Obama's Affordable Care Act, Reuters reported. Insurers are required to cover preventive services the task force recommends.

Catching and treating HIV early may do more for some patients than just reduce risk for the disease progressing into AIDS. A baby born with HIV in Mississippi 2.5 years ago has been off treatment for about one year after doctors gave a faster, stronger treatment than is typically prescribed within 30 hours of birth.

That fast treatment apparently prevented HIV in the baby's blood from forming disease stores called reservoirs, which are dormant cells that can rapidly re-infect people who stop taking their antiretroviral medication.

French scientists in March also announced 14 patients who were treated with medication within weeks of infectionhave no disease activity one year after stopping treatment. Not all patients studied were able to keep the disease at bay, with the researchers estimating up to 15 percent of patients with HIB may benefit from rapid treatment after diagnosis.

People with questions on the new guidance can read tihs fact sheet from the U.S. Preventive Services Task Force.

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