Mon, 11 Jan 2010

On December 30, 2008, FDA approved the first nucleic acid test (NAT) that screens for the presence of two divergent types of HIV in donated blood plasma and human tissue. Nucleic acid is the term commonly used to refer to the chemical compounds that make up the genetic material in the virus. The new FDA-approved test detects nucleic acid from HIV-2 and from HIV-1 Group O. HIV-2 infections and HIV-1 Group O infections are predominantly found on the African continent. Some cases of infection with these two types of viruses have also been detected in the United States.

The new test, called cobas TaqScreen MPX Test, will allow blood donor testing laboratories to use nucleic acid technology to screen for additional the HIV strains, further assuring that donated blood and tissue are free from infection and providing better protection for patients. However, FDA is not requiring screening with the new test at this time.

In addition to HIV-2 and HIV-1 Group O, the MPX test simultaneously detects nucleic acid from the most common form of HIV, HIV-1 Group M, as well as the Hepatitis C Virus and the Hepatitis B Virus.

Mon, 11 Jan 2010

In a joint press conference on April 17, the American College of Physicians and the HIV Medicine Association made an urgent call for national AIDS policy reform, including universal testing for everyone who does not opt out.

Dr. Michael S. Saag, director of the University of Alabama-Birmingham's Center for AIDS Research, moderated the press conference. While noting the "incredible progress" that has occurred in the field since the onset of the epidemic in the early 1980s, Saag said, "our policies have not really been revisited in a serious way."

Saag and other speakers observed that while CDC has recommended routine HIV testing since 2006, many insurers still do not pay for the test. They noted that the transmission of HIV from mothers to infants has been halted in the United States by universal screening of pregnant women. "The same concept needs to be applied to the entire population," Saag said. He noted that in the university's 1917 Clinic for HIV, about half the patients who present for treatment already have severely compromised immune systems, meaning they are being diagnosed too late for optimal treatment.

Mon, 11 Jan 2010

One "significant area" in which CDC guidelines on communicable diseases have not been followed is HIV testing, specifically the agency's recommendations issued in 2006 that HIV testing become a part of routine care for people ages 13 to 64, a Houston Chronicle editorial says, adding that routine HIV testing is a "crucial step, experts say, in preventing new cases, since the disease is spread most commonly by people who are unaware that they are infected." According to the editorial, CDC is investing more than $35 million in a national testing program with the goal of screening 1.5 million people in 2009. Researchers predict that of those 1.5 million people, about 20,000 will test positive for HIV, the editorial says. It adds that Houston is "fortunate" to be one of the 25 areas involved in the initiative, with four Houston centers participating.

Mon, 11 Jan 2010

"Clinicians Advised To Step Up HIV Tests," Journal of the American Medical Association: The article examines recommendations from HIV/AIDS experts regarding routine HIV testing and suggests that many medical service providers miss opportunities to conduct HIV tests. According to the article, HIV/AIDS experts endorse CDC's 2006 recommendations that medical workers offer routine HIV screening to all patients between ages 13 and 64; however, routine HIV tests have not been implemented widely. The article continues that rapid screening using a saliva test can provide an easy, accurate HIV diagnosis in a short amount of time. In addition, routine testing could increase HIV/AIDS awareness and help several thousand people access antiretroviral treatment while preventing new HIV cases. However, a lack of sufficient reimbursement from insurance companies, as well as Medicare and Medicaid, poses obstacles to increasing HIV testing, some experts say. In addition, recent studies indicate that hospital emergency departments often miss opportunities to provide HIV tests to patients who are uninsured and might have no other source of regular health care, according to the article

Mon, 11 Jan 2010

The guidelines differ slightly from those of the federal Centers for Disease Control and Prevention, which recommends routine screening of patients until age 64 unless the prevalence of H.I.V. is known to be less than 0.1 percent in the patient population. The recommendations also differ from those put forth by the U.S. Preventive Services Task Force, which urges routine screening only of patients at increased risk for infection.