Early diagnosis of HIV infection provides timely access to HAART, OI prophylaxis, and treatment of other co-infections, thus improving patient outcomes, including quality of life. Palella F.J, et al. Survival Benefit of Initiating Antiretroviral Therapy in HIV-Infected Persons in Different CD4+ Cell Strata. Ann Intern Med 2003; 138:620-6.
A recent study of 15,934 treatment-naïve veterans who initiated antiretroviral (ARV) treatment between 1992 and 2004 showed substantial numbers beginning ARV at CD4+ cell levels lower than recommended. This was considered to be a consequence of late diagnosis of HIV infection, rather than a failure of healthcare providers to adhere to treatment guidelines recommendations. Holodniy M., et al. Relationship between Antiretroviral Prescribing Patterns and Treatment Guidelines in Treatment-Naive HIV-1 Infected US Veterans (1992-2004). J AIDS 2007; 44:20-29.
A patient's knowledge of his or her HIV status substantially reduces high-risk behaviors. In theory, new sexually transmitted HIV infections could be reduced by more than 30% per year if all HIV-infected persons knew of their infection, and adopted changes in behavior similar to those of persons already aware of their infection. Marks G., et al. Estimating Sexual Transmission of HIV from Persons Aware and Unaware that they are Infected with the virus in the USA. AIDS 2006; 20:1447-1450.
With the advent of vastly improved anti-retroviral treatments, early diagnosis of HIV infection has become critical for medical and public health reasons, especially since CDC estimates that as many as one-quarter of one million HIV infected Americans are unaware of their HIV infection. Centers for Disease Control and Prevention. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. MMWR 2006; 55 (No. RR-14)
Hepatitis C-related liver disease progresses more rapidly in co-infected patients. Since the introduction of potent anti-retroviral therapy has led to longer survival in patients with HIV infection, liver disease has become a leading cause of death in HIV-infected patients. Thomas DL. Hepatitis C and Human Immunodeficiency Virus Infection. Hepatology 2002; 36:201-209.
For more information, visit http://www.publichealth.va.gov or call (202) 273-8567.
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