Comments on the Recent Clinical Guidance Statement on HIV Screening

摘要: Although we agree in principle with the guidelines setforth by Qaseem and colleagues (1) regarding HIV screening havegenerally adopted similar practices our clinics, are concerned thatsome consequences of universal were not addressed thisarticle. Specifically, assuming sensitivity specificity to be greaterthan 99% greater than 99.99%, respectively, for sequentialscreening test (initial enzyme immunoassay followed either confirma-tory Western blot or immunofluorescent assay) U.S. populationestimate number persons older 13 years 244 926 386persons (2), then applying sequential this popula-tion would result 24 393 false-positive results. This is anunfortunate consequence screening, no mention ismade cost misdiagnosis, which could involve unnecessary med-ical intervention squandering limited health care resources (3).In addition, results may develop se-vere psychosocial distress (4) unable obtain insur-ance. These cases substantial financial healthcare system respect litigation (5). Furthermore, many thou-sands positive on initial immuno-assay before testing negative a confirmatory test, wouldresult stress these as well. Therefore, al-though broader approaches warranted, medical practi-tioners who initiate must educated poten-tial future guideline statements areconstructed screening.