New York City’s Refusal To Use Viral Load Testing for HIV Diagnosis Will Not Prevent Infections, Opinion Piece Says
Despite the availability of a "reliable method to detect [the] initial phase" of HIV infection -- which is when the amount of HIV in the bloodstream, or the viral load, is highest -- most health care providers and the New York City government do not use or promote viral load testing for HIV diagnosis, Paul Galatowitsch, a health care consultant; Antonio Urbina, director of clinical HIV/AIDS education at Saint Vincent Catholic Medical Centers in New York City; and Timothy Law Snyder, a math and computer science professor at Fairfield University in Connecticut, write in a New York Times opinion piece. Unlike the standard HIV test -- which detects antibodies to the virus that develop weeks or sometimes months after infection -- the viral load test can detect the virus's presence within a week after infection, the authors say. The test "is the most useful in stopping the spread of" HIV because the first few weeks of infection "correspond to the period of highest infectivity," according to the authors. Although viral load testing is expensive -- costing $200 to $300 per test -- especially when compared with antibody testing, which costs about $5 per test, using the viral load test on pooled blood samples that tested HIV-negative on antibody tests would save the city $1.8 million to $21.6 million annually, identify an additional 24 to 36 cases of acute HIV infection and avert six to 72 HIV transmissions each year, the authors say. "The decision not to combine rapid HIV antibody and viral load testing will incur needless tragedies for many New Yorkers and cost the city millions of dollars in additional health care expenses," the authors conclude (Galatowitsch et al., New York Times, 7/17).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.