Researchers: All Americans Should Be Tested Routinely for AIDS Virus
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Urging a major shift in U.S. policy, some health experts are recommending that virtually all Americans be tested routinely for the AIDS virus, much as they are for cancer and other diseases.
Since the early years of the AIDS epidemic in the 1980s, the government has recommended screening only in big cities, where AIDS rates are high, and among members of high-risk groups, such as gay men and drug addicts.
But two large, federally funded studies found that the cost of routinely testing and treating nearly all adults would be outweighed by a reduction in new infections and the opportunity to start patients on drug cocktails early, when they work best.
“Given the availability of effective therapy and preventive measures, it is possible to improve care and perhaps influence the course of the epidemic through widespread, effective and cost-effective screening,” Dr. Samuel Bozzette wrote in an editorial accompanying the studies, which appear in today’s New England Journal of Medicine.
A failure to institute such screening at doctors’ offices and clinics would be “a critical disservice” to patients with the AIDS virus and “the future health of the nation,” wrote Dr. Bozzette, who is from the University of California at San Diego and the Rand Corp. think tank in Santa Monica, Calif.
Dr. Robert Janssen, director of HIVAIDS prevention at the Centers for Disease Control and Prevention, said the CDC will re-evaluate its guidelines over the next two years, and will consider the study’s findings as well as the availability of new, rapid HIV tests that produce results in a half-hour instead of the usual week or two.
Who would bear the cost of expanded testing – and the cost of the treatment, which runs to at least $15,000 a year – remains a sticky question amid government cutbacks in health-care funding. However, Dr. Janssen said the studies’ findings could lead to some private insurers to encourage more HIV testing.
One of the studies estimated that routine one-time testing of everyone would cut new infections each year by a little more than 20%, and that every HIV-infected patient identified would gain an average of 18 months of life.
