Time for Oncologists to Opt In for Routine Opt-Out HIV Testing?
Time for Oncologists to Opt In for Routine Opt-Out HIV Testing?
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DOI：
10.1001/jama.2010.752
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发表时间：
2010-07-21
影响因子：
120.7
通讯作者：
Pantanowitz, Liron
中科院分区：
文献类型：
--
作者：
Chiao, Elizabeth Y.;Dezube, Bruce J.;Pantanowitz, Liron
人类免疫缺陷病毒(HIV)感染者患恶性肿瘤的风险很高。然而，对癌症患者进行常规艾滋病毒检测并不是目前的护理标准。2006年，疾病控制和预防中心建议在所有医疗保健机构进行艾滋病毒检测，呼吁进行标准的非定向“选择退出”艾滋病毒筛查。由于各种原因，常规的选择退出艾滋病毒检测在美国仍然没有广泛使用。虽然常规选择退出艾滋病毒检测的许多障碍已经解决，但这种选择退出艾滋病毒检测仍然主要在针对特定患者群体(如孕妇)的场所进行。尽管选择退出检测已经在急诊科进行了试点，但在其他临床环境中选择退出艾滋病毒检测的重视程度较低。在这篇文章中，提出了支持选择退出艾滋病毒检测作为癌症患者常规护理的背景、理由和证据。此外，还讨论了选择退出艾滋病毒检测通过促进在癌症治疗期间对被发现为艾滋病毒阳性的个人进行适当的艾滋病毒管理来改善临床结果的可能性。贾玛2010；304(3)：334-339 www.jama.com
Human immunodeficiency virus (HIV)-infected individuals are at high risk of malignancies. However, it is not currently the standard of care to routinely test cancer patients for HIV. In 2006, the Centers for Disease Control and Prevention recommended HIV testing in all health care settings, calling for standard nontargeted "opt-out" HIV screening. For a variety of reasons, routine opt-out HIV testing is still not widely used in the United States. Although many barriers to routine opt-out HIV testing have been addressed, such opt-out HIV testing continues to be conducted primarily in venues that target specific patient populations such as pregnant women. Although opt-out testing has been piloted in emergency departments, less emphasis has been placed on opt-out HIV testing in other clinical settings. In this article, the background, rationale, and evidence for supporting opt-out HIV testing as routine care for cancer patients are presented. In addition, evidence is discussed for the potential of opt-out HIV testing to improve clinical outcomes by facilitating appropriate HIV management during cancer treatment for individuals who are found to be HIV positive. JAMA. 2010;304(3):334-339 www.jama.com