HIV

Annual HIV Diagnosis Rate Has Fallen Over 30%

Panel Releases New HIV Treatment and Prevention Guidelines

A US panel of the International Antiviral Society has released 2 sets of guidelines on the treatment and prevention of HIV in conjunction with the 2014 AIDS International Conference.

The treatment guidelines come in response to new data and antiretroviral regimens that expand treatment choices significantly enough to warrant updates, according to the panel. 
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Recommendations include:

  • Antiretroviral therapy (ART) is recommended for the treatment of HIV infection and for the prevention of transmission of HIV regardless of CD4 cell count.
  • ART should be started as soon as possible, preferably within the first 2 weeks of diagnosis, in patients with opportunistic infections (AIa) and other opportunistic diseases and AIDS-defining illnesses (including all lymphomas and human papillomavirus–related cancers)

The prevention guidelines incorporate new data on biomedical and behavioral methods, including:

  • All adults and adolescents should be offered HIV testing at least once.
  • Persons at higher risk (those engaging in risk behaviors or residing in areas of or testing at venues with high seroprevalence) should be tested more frequently, at intervals appropriate to the individual’s situation.
  • Self-testing and home testing should be considered for those who have recurrent risk, difficulties with testing in clinical settings, or both.
  • Simultaneous access to ART, needle and syringe exchange programs, supervised injection sites, medicalized heroin, and medically assisted therapy (which includes opioid-substitution therapy) should be provided to HIV-infected people who inject drugs.
  • Preexposure prophylaxis should be part of an integrated risk-reduction strategy, so its use may become unnecessary if a person’s behavior changed.

Annual HIV Diagnosis Rate Has Fallen Over 30%

Also published this week, in conjunction with the timing of the AIDS International Conference, was a new study from researchers at the CDC, which reported that between 2002 and 2001, the annual diagnosis rate of HIV fell by over 30%.

Using data from the CDC’s National HIV Surveillance System, recording 493,372 new diagnoses during the 10-year period, researchers found that rates dropped from 24.1 cases per 100,000 in 2002 to 16.1 per 100,000 in 2011, a decrease of 33.2%. 

The largest changes in diagnosis rates were in women and individuals between 35 and 44 years old.

Despite the significant decreases, researchers reported observing a 132.5% increase in HIV diagnosis among males between 13 and 24 years old.  Increases were also observed in men who have sex with men. 

This is the first long-term examination of national trends of HIV diagnosis rates, made possible by state-by-state data that only recently became available.

“These data can be used to monitor awareness of serostatus among persons living with HIV, primary prevention efforts, and testing initiatives,” they concluded.

The study was published in JAMA.

–Michael Potts

 

References

Gunthard HF, Aberg JA, Eron JJ, Hoy JF, et al. Antiretroviral treatment of adult HIV infection. JAMA. 2014;312(4):410-425. doi:10.1001/jama.2014.8722.

Marrazzo JM, Rio C, Holtgrave DR, Cohen MS, et al. HIV prevention in clinical care settings. JAMA. 2014;312(4):390-409. doi:10.1001/jama.2014.7999.

Johnson AS, Hall HI, Hu X, Lansky A, et al. Trends in diagnoses of HIV infection in the United States, 2002-2011. JAMA. 2014;312(4):432-434. doi:10.1001/jama.2014.8534.