Comments on the Recent Clinical Guidance Statement on HIV Screening
Authors: Eliezer M. Van Allen
Journal: Annals of Internal Medicine (2009)

Letters18 August 2009Comments on the Recent Clinical Guidance Statement on HIV ScreeningEliezer M. Van Allen, MD and R. Jeffrey Kohlwes, MD, MPHEliezer M. Van Allen, MDFrom the University of California, San Francisco, San Francisco, CA 94143, and Veterans Affairs Hospital, San Francisco, CA, 94121.Search for more papers by this author and R. Jeffrey Kohlwes, MD, MPHFrom the University of California, San Francisco, San Francisco, CA 94143, and Veterans Affairs Hospital, San Francisco, CA, 94121.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-4-200908180-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Although we agree in principle with the guidelines set forth by Qaseem and colleagues (1) regarding HIV screening and have generally adopted similar practices in our clinics, we are concerned that some consequences of universal screening were not addressed in this article. Specifically, assuming the sensitivity and specificity to be greater than 99% and greater than 99.99%, respectively, for the sequential screening test (initial enzyme immunoassay followed by either confirmatory Western blot or immunofluorescent assay) and the U.S. population estimate for number of persons older than 13 years to be 244 926 386 persons (2), then applying sequential universal ...References1. Qaseem A, Snow V, Shekelle P, Hopkins R, Owens DK; Clinical Efficacy Assessment Subcommittee. American College of Physicians. Screening for HIV in health care settings: a guidance statement from the American College of Physicians and HIV Medicine Association. Ann Intern Med. 2009;150:125-31. [PMID: 19047022] LinkGoogle Scholar2. U.S. Census Bureau, Population Division. Annual Estimates of the Population by Sex and Selected Age Groups for the United States: April 1, 2000 to July 1, 2007. NC-EST2007-02; 1 May 2008. Accessed at www.census.gov/popest/national/asrh/NC-EST2007-sa.html on 26 May 2009. Google Scholar3. Grimes DA, Schulz KF. Uses and abuses of screening tests. Lancet. 2002;359:881-4. [PMID: 11897304] CrossrefMedlineGoogle Scholar4. Bhattacharya R, Barton S, Catalan J. When good news is bad news: psychological impact of false positive diagnosis of HIV. AIDS Care. 2008;20:560-4. [PMID: 18484325] CrossrefMedlineGoogle Scholar5. Testing. $350,000 damages affirmed in false HIV-positive case. AIDS Policy Law. 2008;23:7. [PMID: 18985825] Google Scholar Author, Article, and Disclosure InformationAffiliations: From the University of California, San Francisco, San Francisco, CA 94143, and Veterans Affairs Hospital, San Francisco, CA, 94121.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for HIV in Health Care Settings: A Guidance Statement From the American College of Physicians and HIV Medicine Association Amir Qaseem , Vincenza Snow , Paul Shekelle , Robert Hopkins Jr. , Douglas K. Owens , and Comments on the Recent Clinical Guidance Statement on HIV Screening David R. Holtgrave Comments on the Recent Clinical Guidance Statement on HIV Screening Amir Qaseem , Paul Shekelle , and Douglas K. Owens Metrics Cited byDevelopment And Adaptation To Large-Scale Production Immunoenzymatic Test System Increased Sensitivity For Early Diagnosis Of Hiv Infection 18 August 2009Volume 151, Issue 4Page: 286KeywordsConflicts of interestEnzyme immunoassayForecastingHIVHealth careHealth insuranceSpecificityTreatment guidelinesWestern blot ePublished: 18 August 2009 Issue Published: 18 August 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...