U.S.

Will Soon Adopt Free, Universal HIV Testing

Written by Suzanne Boothby | Published on March 6, 2013

A functional cure for one Mississippi child and new recommendations from the USPSTF may lead to free, nationwide HIV screening.

Early screening saves lives, and new evidence reveals miraculous potential in the early identification of HIV infections. This week, researchers announced the first case of a functional cure for HIVmeaning that the virus is in remission without the on-going use of medications. A child born more than two years ago in Mississippi to a mother who did not know she was HIV-positive until the time of delivery was treated with antiretroviral drugs within the first few days of life. The child was treated for ten months and now shows no signs of HIV infection, even after stopping antiretroviral medication, according to findings presented at the Conference on Retroviruses and Opportunistic Infections in Atlanta. "We believe this is the first well-documented case of a [functional] cure," said lead study author Dr. Deborah Persaud, associate professor of pediatrics at Johns Hopkins Children's Center, in a statement. "For us this is a very exciting finding. By treating a baby very early [we may be able to] prevent viral reservoirs or cells that stay around for the lifetime of an infected person." Typically, expectant mothers with HIV take medication that can almost eliminate the chance that the virus will be passed on to the child. If the current "cure" can be replicated in a formal study setting, early and aggressive treatment could be used help those children who are infected at birth, especially in developing nations. Despite the fact that research has given us the tools to prevent mother-to-child transmission of HIV, many infants are unfortunately still born infected, said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases, in a statement. With this case, it appears we may have not only a positive outcome for the particular child, but also a promising lead for additional research toward curing other children.

New Guidelines for HIV Screening

Nearly 56,000 people in the United States become infected with HIV each year. Now, an independent panel of experts in preventive and evidence-based medicine are ready to release a recommendation that all adults and adolescents be screened for HIV/AIDS. The U.S. Preventive Services Task Force (USPSTF) based their decision on new evidence of the clinical and public health benefits of early HIV identification that has emerged since 2005 when they last reviewed the data and opted not to recommend routine screening. The Affordable Care Act (ACA) mandates that all public and private health plans provide coverage for USPSTF-recommended preventive services without patient co-payments, which means that universal testing will be free for everyone with insurance. About 20 percent of the estimated 1.1 million Americans living with HIV are unaware of their status. They consequently lose a critical opportunity to start antiretroviral therapy early and pose a public health risk if they transmit the virus to others. The USPSTF found good evidence that both standard and U.S. Food and Drug Administration (FDA)-approved rapid screening tests accurately detect HIV infection, according to the USPSTF statement. The USPSTF also found good evidence that appropriately timed interventions, particularly highly active antiretroviral therapy (HAART), lead to improved health outcomes for many of those screened, including reduced risk for clinical progression and reduced mortality. Despite significant recent advances in treatment, AIDS is still the seventh leading cause of death in people ages 15 to 24, and the fifth leading cause of death in people ages 25 to 44 in the U.S., according to research from Centers for Disease Control and Prevention.

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