NORTHWESTERN (US) — Current screening guidelines for HIV are too conservative, according to a new study that says more frequent testing would be cost-effective for both high- and low-risk groups.
Early HIV treatment can save lives as well as have profound prevention benefits. But those infected with the virus first must be identified before they can be helped.
The Centers for Disease Control and Prevention currently recommends annual testing for high-risk groups, such as people with HIV-positive sexual partners, people with multiple sexual partners, injection drug users, and sex workers, and once-in-a-lifetime testing for low-risk groups (whose annual risk of acquiring HIV is only one-hundredth of one percent).
Researchers performed a mathematical modeling study to assess “optimal testing frequencies” for HIV screening in different risk groups and concluded screening should be done up to every three months for the highest-risk individuals and low-risk groups should be tested every three years.
“Our results should encourage policymakers and medical professionals to reconsider how often adolescents and adults should be tested for HIV,” says Benjamin Armbruster, assistant professor of industrial engineering and management sciences at Northwestern University.
He and doctoral student Aaron Lucas modeled various scenarios in an attempt to “optimize the tradeoff” between the societal costs of testing versus the benefits of earlier HIV diagnosis over a patient’s lifetime. Their results are published in the March issue of AIDS.
Frequent testing has been shown to be an effective method for identifying new HIV infections. In the past, people with new HIV infections weren’t treated until they had significant declines in immune functioning, as measured by the CD4 cell count.
But there is a growing consensus that antiretroviral treatment is beneficial for all HIV-infected patients, regardless of CD4 count. Starting treatment immediately after diagnosis also reduces the risk of transmitting HIV.
The researchers say that within its limitations, the study suggests that current recommendations for HIV testing are “too conservative, especially for low-risk groups who would benefit from more frequent testing.”
Source: Northwestern University