Task Force issues HIV screening recommendations

All adolescents and adults age 15 to 65 should be screened for HIV infection, the U.S. Preventive Services Task Force said.

The Task Force's current recommendation statement, published early online April 30 by Annals of Internal Medicine, expands on its statement from 2005, which strongly recommended HIV screening in all adolescents and adults at increased risk for infection and in all pregnant women. The Task Force continues to strongly recommend screening in these groups but now also includes all adolescents and adults age 15 to 65 who are not known to be at increased HIV risk. Its recommendations for pregnant women include those who present in labor and have not been tested and those whose HIV status is not known.

To develop the current recommendations, the Task Force reviewed evidence on the effectiveness of HIV treatment in HIV-infected patients with CD4 cell counts above 0.200 × 10⁹ cells/L; the effects of screening, counseling and use of antiretroviral therapy on risk behaviors and risk for HIV transmission; and the cardiovascular harms of antiretroviral therapy over the long term. The current recommendations are Grade A recommendations, meaning that the Task Force recommends the service and there is high certainty that the net benefit is substantial.

The authors of an accompanying editorial questioned the Task Force's focus on the timing of antiretroviral therapy initiation and its potential cardiac risk. However, they noted that the Task Force's recommendations are now mostly in agreement with the 2006 guidelines from the CDC, which call for testing all people between 13 and 64 years of age, and that an increasing consensus has emerged on population-based screening for HIV.