World AIDS Day Calls For HIV Testing
HIV and AIDS organizations are calling for routine testing for HIV to prevent AIDS as they address the World AIDS Day. In particular the American College of Physicians (ACP) is giving doctors a call-to-action to routinely encourage HIV screening to all of their patients older than 13 years. Annals of Internal Medicine presents a guide on the new practice guidelines for the routine HIV testing in your doctor's office.
First we need to recognize the early symptoms of HIV so we can get tested. The signs and symptoms may depend on the stage of the disease. According to Mayo Clinic in the early stage of HIV "you may have no signs or symptoms at all, although it's more common to develop a brief flu-like illness two to four weeks after becoming infected. Signs and symptoms may include fever, headache, sore throat, swollen lymph glands and rash." However in the later state of HIV infection "You may remain symptom-free for eight or nine years or more. But as the virus continues to multiply and destroy immune cells, you may develop mild infections or chronic symptoms such as: swollen lymph nodes - often one of the first signs of HIV infection, diarrhea, weight loss, fever, cough and shortness of breath."
Now the group of ACP doctors and internists have developed the following guidelines for a routine HIV testing, which are also endorsed by the HIV Medicine Association. Read About HIV Transmission >>
The authors identified 2 guidelines about screening for HIV infection. In 2005 (and updated in 2007), the U.S. Preventive Services Task Force (USPSTF) recommended that doctors routinely ask patients about HIV risk factors, patients tell their doctors if they have a risk factor, and doctors recommend HIV testing for all adolescents and adults with a risk factor. The USPSTF also recommends screening all pregnant women. In 2006, the Centers for Disease Control and Prevention (CDC) recommended routine screening for all patients 13 to 64 years of age unless they lived in an area where HIV infection occurs in fewer than 1 of every 1000 residents. The CDC also recommends screening pregnant women and patients with tuberculosis or sexually transmitted diseases.
Research shows that early diagnosis and treatment of HIV infection extends life and also decreases the spread of HIV infection to other people. Research also suggests that programs that screen only high-risk patients fail to identify substantial numbers of people with early HIV infection. Studies of screening in pregnant women suggest that acceptance of screening is high. Studies also suggest that the benefits of screening are worth the costs, especially if screening reduces the spread of HIV infection.
What does the ACP suggest that patients and doctors do?
The ACP recommends that doctors routinely encourage HIV screening for all patients older than 13 years regardless of whether HIV risk factors are present. The ACP recommends that doctors determine the need for repeated screening on the basis of the individual patient's risk for infection. Recommendations may change as new studies become available. The authors did not examine guidelines from countries other than the United States.
HIV is a virus that causes AIDS, an illness that interferes with the body's ability to fight infection and some types of cancer. Treatments containing multiple drugs have improved outcomes for HIV-infected patients. HIV passes from person to person through contact with blood or other body fluids that contain the virus. People can have HIV infection for years before becoming sick.
Testing for HIV infection involves a blood test. Screening means testing people who feel well rather than waiting until symptoms develop. Different organizations have different recommendations for HIV screening. The ACP wanted to review the recommendations of other organizations and recent research to guide doctors in light of differing recommendations from other organizations. Medicare Doesn't Cover Routine HIV Screening >>
CDC explains that the most common HIV tests use blood to detect HIV infection. Tests using saliva or urine are also available. Some tests take a few days for results, but rapid HIV tests can give results in about 20 minutes. All positive HIV tests must be followed up by another test to confirm the positive result. Results of this confirmatory test can take a few days to a few weeks.
In most HIV screening cases the EIA (enzyme immunoassay), used on blood drawn from a vein, is the most common screening test used to look for antibodies to HIV. A positive (reactive) EIA must be used with a follow-up (confirmatory) test such as the Western blot to make a positive diagnosis. There are EIA tests that use other body fluids to look for antibodies to HIV. These include Oral Fluid Tests and Urine Tests.
There are also the Rapid Tests, RNA Tests and the Home Testing Kits that were first licensed in 1997. Although home HIV tests are sometimes advertised through the Internet, currently only the Home Access HIV-1 Test System is approved by the Food and Drug Administration. (The accuracy of other home test kits cannot be verified).
The above HIV Testing guidelines intend to prevent the unwanted spread and transmission of HIV and AIDS Virus. It is said that AIDS can be eliminated in a decade if we make access to prevention and treatment means universally available for the developing countries as well. The World AIDS Day is a very good opportunity to raise awareness and call for action to fight HIV and AIDS.