HIV screen for all in pregnancy: USPSTF.(Obstetrics)

Physicians should screen all pregnant women for HIV infection, according to updated recommendations from the U.S. Preventive Services Task Force.

The task force--an independent panel of experts in prevention and primary care--recommended in 1996 that physicians routinely screen and counsel pregnant women at high risk for HIV and those living in communities with high rates of HIV-infected newborns.

At that time, the task force did not find sufficient evidence to recommend for or against routine screening for pregnant women without identified risk factors for HIV.

The updated recommendation is based on "good evidence" that both standard and rapid screening tests can accurately detect HIV infection in pregnant women and "fair evidence" that the universal prenatal counseling and voluntary testing increases the proportion of HIV-infected women who are diagnosed and treated before delivery (Ann. Intern. Med. 2005;143:32-7).

The task force also determined that there is "good evidence" that treatments such as highly active antiretroviral therapy (HAART) can lead to significantly reduced rates of HIV transmission from mother to child.

"Early identification of maternal HIV seropositivity allows early antiretroviral treatment to prevent mother-to-child transmission, allows providers to avoid obstetric practices that may increase the risk for transmission, and allows an opportunity to counsel the mother against breast-feeding," the task force said.

About 40,000 people are infected with HIV each year in the United States; this number includes about 300 cases of mother-to-child transmission, the task force reported.