Navigation Links
Universal HIV testing and immediate treatment could reduce but not eliminate HIV/AIDS epidemic
Date:7/9/2010

Implementing a program of universal HIV testing and immediate antiretroviral treatment (ART) for infected individuals could have a major impact on the HIV/AIDS epidemic in Washington, DC, but a new study finds that it would not halt the epidemic, something that a previous report had projected. In a paper that will appear in the August 15 issue of Clinical Infectious Diseases and has been released online, researchers find that the so-called "test-and-treat" strategy could reduce new HIV infections by 15 percent over the next five years while conferring large survival benefits to HIV-infected patients.

"Test-and-treat will save lives, but it won't stop the HIV epidemic in its tracks all by itself," says Rochelle P. Walensky, MD, MPH, of the Massachusetts General Hospital (MGH) Division of Infectious Disease, who led the study." It is only a single new and important page in the HIV-prevention playbook."

Test-and-treat has been the subject of widespread interest and controversy in the scientific community. In January 2009, WHO scientists published a report in The Lancet suggesting that a voluntary system of annual HIV testing of all adults, followed by immediate provision of ART for those testing positive, "could nearly stop transmission and drive HIV into an elimination phase." Inspired by these findings, researchers and public health officials have rushed to design and implement test-and-treat studies and interventions. The National Institute for Allergy and Infectious Diseases (NIAID) recently announced a two-year, $26.4 million partnership with the Washington, DC, Department of Health that includes a pilot study of the test-and-treat strategy. However, some experts have expressed concern that the assumptions underlying the WHO findings painted too optimistic a picture of the likely outcomes.

The current study used epidemiologic data and results from HIV screening programs conducted in the U.S. capital to give a realistic picture of the likely impact of a test-and-treat effort in that city, which has one of the nation's largest rates of HIV infection. This contrasts with the WHO study which employed data from sub-Saharan Africa and assumed truly universal screening and treatment with optimal clinical outcomes. "The reality of HIV screening programs, even the best ones, is that many people are never reached for screening, some refuse screening or do not link to care, and many of those who are treated do not maintain viral suppression," notes Kenneth A. Freedberg, MD, MSc, of the MGH Department of Medicine, the report's senior author.

The study finds that a test-and-treat program in Washington, DC, could extend life expectancy of HIV-infected patients currently projected at about 24 years after diagnosis another one to two years and could reduce the rate of new infections 15 percent over a five-year period. Survival and prevention impacts would be even greater with improvements in screening, linkage to treatment and retention in care improvements not yet reflected in the "best cases" reported by any U.S. program. Such optimistic but possibly achievable scenarios could extend survival to 29 years after HIV diagnosis and decrease new infections by as much as 50 percent over five years.

"The benefits of expanded testing to persons with undiagnosed HIV infection are unquestioned," Walensky says. "Earlier detection and linkage to care saves lives; this alone is a reason for test-and-treat. But pinning all our hopes on the latest 'magic bullet,' underestimating the logistical obstacles, and forgetting that prevention requires an integrated package of strategies puts us at risk of falling into a trap we've seen before. Our analysis suggests that test-and-treat will likely be a very important addition to the treatment and prevention armamentarium, but the expectations for its impact should be realistic."


'/>"/>

Contact: : Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
Source:Eurekalert

Related medicine news :

1. Mount Sinai researchers approaching universal treatment for all strains of influenza
2. Mount Sinai researchers move closer to a universal influenza vaccine
3. Universal Health Care Debate Coincides with Release of My eMHR, the Nation's First Free Electronic Personal Health Records System
4. New York State Adopts Universal Provider Datasource to Reduce Administrative Costs for Medicaid
5. Families Fighting Flu Commends the CDCs Advisory Committee on Immunization Practices Recommendation for Universal Influenza Vaccination
6. Universal Health Realty Income Trust Reports 2009 Fourth Quarter and Full Year Financial Results
7. HPV DNA testing over 50 percent more sensitive than cytology testing
8. Lifeloc supports workplace breath alcohol testing and announces new robust solution, the EV30T
9. QualEDIx Announces the Launch of the Nation's Only Managed Service Model for HIPAA 5010 and ICD-10 Testing
10. Scripps Center for Executive Health Now Offers Genetic Testing
11. Gender gap persists at highest levels of math and science testing
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/28/2017)... Washington, DC (PRWEB) , ... April 28, 2017 ... ... Unplanned Pregnancy (The National Campaign) announces its support for the Access to ... by Sen. Jeanne Shaheen (D-NH) and Rep. Jackie Speier (D-CA), will help to ...
(Date:4/28/2017)... ... April 28, 2017 , ... ... integration of Microsoft(R) Word(TM) Online(TM), which enables sleep physicians to create and edit ... the reporting process and provides a familiar interface that does not require additional ...
(Date:4/28/2017)... ... April 28, 2017 , ... Getting enough sleep affects much more than energy – ... just 19 hours without sleep can compromise motor reaction time, which can increase the risk ... Insurance is sharing the following tips from the NSF to help you sleep better and ...
(Date:4/28/2017)... ... April 28, 2017 , ... Ushio America proudly introduces the ... instant energy-saving solution for F32T8 fluorescent lamps on most instant-start and programmed-start electronic ... hour rated lamps utilize the existing electronic ballast, saving labor and maintenance costs. ...
(Date:4/28/2017)... ... April 28, 2017 , ... Children ... to more adverse experiences than children in the general population. That’s because foster ... neglect or other family challenges. While no fault of their own, youth who ...
Breaking Medicine News(10 mins):
(Date:4/26/2017)... , April 26, 2017 Phoenix Marketing Solutions ... fifteenth year of fulfilling its mission of transforming science into ... highly scrutinized, Phoenix,s innovative approach supports ... community about the latest advances in science and medicine — ... was founded in 2002 by Tracy Doyle ...
(Date:4/24/2017)... England , April 24, 2017 ... development, today announced the addition of a major ... ,Validated In-situ Plate Seeding,). The VIPS has been ... and 384 well microplates as part of the ... system offers a simple and more reliable solution ...
(Date:4/20/2017)...  Vivify Health, the pioneer and market leader of ... very significant patent for the advancement of healthcare delivery ... digital health.  This landmark patent provides the company with ... Vivify,s position as the leader in remote care.  ... company to apply consumer mobile devices, wireless biometrics, EMR ...
Breaking Medicine Technology: