Comments on the Recent Clinical Guidance Statement on HIV Screening
Authors: Amir Qaseem
Journal: Annals of Internal Medicine (2009)

Letters18 August 2009Comments on the Recent Clinical Guidance Statement on HIV ScreeningAmir Qaseem, MD, PhD, MHA, Paul Shekelle, MD, PhD, and Douglas K. Owens, MD, MSAmir Qaseem, MD, PhD, MHAFrom American College of Physicians, Philadelphia, PA 19106; RAND, Santa Monica, CA 90401; and Stanford University, Stanford, CA 94305.Search for more papers by this author, Paul Shekelle, MD, PhDFrom American College of Physicians, Philadelphia, PA 19106; RAND, Santa Monica, CA 90401; and Stanford University, Stanford, CA 94305.Search for more papers by this author, and Douglas K. Owens, MD, MSFrom American College of Physicians, Philadelphia, PA 19106; RAND, Santa Monica, CA 90401; and Stanford University, Stanford, CA 94305.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-4-200908180-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Drs. Van Allen and Kohlwes and Dr. Holtgrave for their comments regarding the American College of Physicians' recent clinical guidance statement on screening for HIV. Drs. Van Allen and Kohlwes are concerned about the potential for false-positive test results with widespread screening. Their example notes a specificity of 99.99% and estimates a substantial number of false-positive test results. In well-controlled testing programs using traditional HIV tests (enzyme immunoassay followed by Western blot) (1), the specificity of the sequence of antibody tests is as high as 99.9994% (1); therefore, false-positive results will be rare and far fewer ...References1. Sanders GD, Bayoumi AM, Sundaram V, Bilir SP, Neukermans CP, Rydzak CE, et al. Cost-effectiveness of screening for HIV in the era of highly active antiretroviral therapy. N Engl J Med. 2005;352:570-85. [PMID: 15703422] CrossrefMedlineGoogle Scholar2. Walensky RP, Arbelaez C, Reichmann WM, Walls RM, Katz JN, Block BL, et al. Revising expectations from rapid HIV tests in the emergency department. Ann Intern Med. 2008;149:153-60. [PMID: 18678842] LinkGoogle Scholar3. Chou R, Huffman LH, Fu R, Smits AK, Korthuis PT; U.S. Preventive Services Task Force. Screening for HIV: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2005;143:55-73. [PMID: 15998755] LinkGoogle Scholar4. Chou R, Huffman L. Screening for human immunodeficiency virus: focused update of a 2005 systematic evidence review for the U.S. Preventive Services Task Force. Rockville, MD: Agency for Healthcare Research and Quality; 2007. AHRQ publication no. 07-0597-EF-1. Google Scholar5. Branson BM, Handsfield HH, Lampe MA, Janssen RS, Taylor AW, Lyss SB, et al; Centers for Disease Control and Prevention (CDC). Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. 2006;55:1-17; quiz CE1-4. [PMID: 16988643] Google Scholar Author, Article, and Disclosure InformationAuthors: Amir Qaseem, MD, PhD, MHA; Paul Shekelle, MD, PhD; Douglas K. Owens, MD, MSAffiliations: From American College of Physicians, Philadelphia, PA 19106; RAND, Santa Monica, CA 90401; and Stanford University, Stanford, CA 94305.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for HIV: A Review of the Evidence for the U.S. Preventive Services Task Force Roger Chou , Laurie Hoyt Huffman , Rongwei Fu , Ariel K. Smits , and P. Todd Korthuis Revising Expectations from Rapid HIV Tests in the Emergency Department Rochelle P. Walensky , Christian Arbelaez , William M. Reichmann , Ron M. Walls , Jeffrey N. Katz , Brian L. Block , Matthew Dooley , Adam Hetland , Simeon Kimmel , Jessica D. Solomon , and Elena Losina Screening 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. , and Douglas K. Owens , for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians* Comments on the Recent Clinical Guidance Statement on HIV Screening Eliezer M. Van Allen and R. Jeffrey Kohlwes Comments on the Recent Clinical Guidance Statement on HIV Screening David R. Holtgrave Metrics 18 August 2009Volume 151, Issue 4Page: 287KeywordsConflicts of interestEnzyme immunoassayHIVPatientsSpecificityWestern blot ePublished: 18 August 2009 Issue Published: 18 August 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...