DiNenno Elizabeth A, Prejean Joseph, Irwin Kathleen, Delaney Kevin P, Bowles Kristina, Martin Tricia, Tailor Amrita, Dumitru Gema, Mullins Mary M, Hutchinson Angela B, Lansky Amy
Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.
MMWR Morb Mortal Wkly Rep. 2017 Aug 11;66(31):830-832. doi: 10.15585/mmwr.mm6631a3.
CDC's 2006 recommendations for human immunodeficiency virus (HIV) testing state that all persons aged 13-64 years should be screened for HIV at least once, and that persons at higher risk for HIV infection, including sexually active gay, bisexual, and other men who have sex with men (MSM), should be rescreened at least annually (1). Authors of reports published since 2006, including CDC (2), suggested that MSM, a group that is at highest risk for HIV infection, might benefit from being screened more frequently than once each year. In 2013, the U.S. Preventive Services Task Force (USPSTF) found insufficient evidence to specify an HIV rescreening interval but recommended annual screening for MSM as a reasonable approach (3). However, some HIV providers have begun to offer more frequent screening, such as once every 3 or 6 months, to some MSM. A CDC work group conducted a systematic literature review and held four expert consultations to review programmatic experience to determine whether there was sufficient evidence to change the 2006 CDC recommendation (i.e., at least annual HIV screening of MSM in clinical settings). The CDC work group concluded that the evidence remains insufficient to recommend screening more frequently than at least once each year. CDC continues to recommend that clinicians screen asymptomatic sexually active MSM at least annually. Each clinician can consider the benefits of offering more frequent screening (e.g., once every 3 or 6 months) to individual MSM at increased risk for acquiring HIV infection, weighing their patients' individual risk factors, local HIV epidemiology, and local testing policies.
美国疾病控制与预防中心(CDC)2006年发布的人类免疫缺陷病毒(HIV)检测建议指出,所有13至64岁的人群都应至少接受一次HIV筛查,而HIV感染风险较高的人群,包括有性行为的男同性恋者、双性恋者以及其他与男性发生性行为的男性(MSM),应至少每年重新筛查一次(1)。自2006年以来发表的报告的作者,包括CDC(2),建议MSM这一HIV感染风险最高的群体,可能会从每年筛查一次以上中受益。2013年,美国预防服务工作组(USPSTF)发现没有足够的证据来确定HIV重新筛查的间隔时间,但建议对MSM进行年度筛查作为一种合理的方法(3)。然而,一些HIV检测机构已开始为一些MSM提供更频繁的筛查,如每3或6个月一次。一个CDC工作小组进行了系统的文献综述,并举行了四次专家咨询会议来审查项目经验,以确定是否有足够的证据来改变2006年CDC的建议(即在临床环境中对MSM至少每年进行一次HIV筛查)。CDC工作小组得出结论,证据仍然不足,无法建议比每年至少一次更频繁地进行筛查。CDC继续建议临床医生至少每年对无症状的有性行为的MSM进行筛查。每位临床医生可以考虑为感染HIV风险增加的个体MSM提供更频繁筛查(如每3或6个月一次)的益处,权衡其患者的个体风险因素、当地的HIV流行病学情况以及当地的检测政策。