Featured Research

from universities, journals, and other organizations

Universal HIV testing and immediate treatment could reduce but not eliminate HIV/AIDS epidemic

Date:
July 12, 2010
Source:
Massachusetts General Hospital
Summary:
Implementing a program of universal HIV testing and immediate antiretroviral treatment for infected individuals could have a major impact on the HIV/AIDS epidemic in Washington, D.C., but a new study finds that it would not halt the epidemic, something that a previous report had projected.

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.

Related Articles


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."

Walensky and Freedberg are both associate professors of Medicine at Harvard Medical School. Additional co-authors of the Clinical Infectious Diseases report are Bethany Morris, Callie Scott, MSc, and Erin Rhode, MS, MGH Department of Medicine; A. David Paltiel, PhD, Yale School of Medicine; Elena Losina, PhD, Brigham and Women's Hospital; and George Seage, ScD, Harvard School of Public Health. The study was supported by grants from the NIAID, the National Institute of Mental Health and the Doris Duke Charitable Foundation.


Story Source:

The above story is based on materials provided by Massachusetts General Hospital. Note: Materials may be edited for content and length.


Cite This Page:

Massachusetts General Hospital. "Universal HIV testing and immediate treatment could reduce but not eliminate HIV/AIDS epidemic." ScienceDaily. ScienceDaily, 12 July 2010. <www.sciencedaily.com/releases/2010/07/100709155514.htm>.
Massachusetts General Hospital. (2010, July 12). Universal HIV testing and immediate treatment could reduce but not eliminate HIV/AIDS epidemic. ScienceDaily. Retrieved November 20, 2014 from www.sciencedaily.com/releases/2010/07/100709155514.htm
Massachusetts General Hospital. "Universal HIV testing and immediate treatment could reduce but not eliminate HIV/AIDS epidemic." ScienceDaily. www.sciencedaily.com/releases/2010/07/100709155514.htm (accessed November 20, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, November 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

UN Says It Will Scale Up Its Ebola Response

UN Says It Will Scale Up Its Ebola Response

AFP (Nov. 20, 2014) — UN Resident Coordinator David McLachlan-Karr and WHO representative in the country Daniel Kertesz updated the media on the UN Ebola response on Wednesday. Duration: 00:51 Video provided by AFP
Powered by NewsLook.com
Takata Offers "sincerest Condolences" To Victims of Malfunctioning Airbag

Takata Offers "sincerest Condolences" To Victims of Malfunctioning Airbag

Reuters - US Online Video (Nov. 20, 2014) — U.S. Congress hears from a victim and company officials as it holds a hearing on the safety of Takata airbags after reports of injuries. Rough Cut (no reporter narration). Video provided by Reuters
Powered by NewsLook.com
Obesity Costs Almost As Much As War And Terrorism

Obesity Costs Almost As Much As War And Terrorism

Newsy (Nov. 20, 2014) — The newest estimate of the cost of obesity is pretty jarring — $2 trillion. But how did researchers get to that number? Video provided by Newsy
Powered by NewsLook.com
Ebola Crisis Affecting US Adoptions

Ebola Crisis Affecting US Adoptions

AP (Nov. 20, 2014) — The Sanborn family had hoped they'd be able to bring home their 5-year-old adopted son from Liberia by now. But Ebola has forced them to wait. The boy is just one of thousands of orphans in West Africa who've been impacted by the deadly virus. (Nov. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins