NYT: H.I.V. Tests Pose Choice of Breakthroughs

H.I.V. Tests Pose Choice of Breakthroughs
By RICHARD PÉREZ-PEÑA
Published: June 6, 2005


For almost two decades, H.I.V. tests had two glaring flaws. They did not detect the earliest stage of infection, when people are more likely to spread the virus. And they took days to produce results, and many people never returned to learn whether they were infected.

Now, technology has put public health officials in a quandary: which problem to address. New generations of tests can largely eliminate either the long waiting time for results, or the failure to find early infections. But the choice is pulling H.I.V. specialists in competing directions, in New York City and nationally. Experts on both sides of the debate would like both types of tests used, but say that expense and logistics make that impractical.

Some health agencies, including those in New York City and New York State, have embraced quick tests that produce preliminary results in minutes, rather than days. North Carolina and San Francisco have gone another way, adopting tests that catch many early infections with H.I.V., the virus that causes AIDS, that other tests miss.

A group of prominent H.I.V. doctors and researchers in New York City say North Carolina and San Francisco made the right call, and they are urging the city's Department of Health and Mental Hygiene to change directions.

"Nobody is criticizing the city, because they've been very proactive on this," said Dr. Frederick P. Siegal, medical director of the H.I.V. center at St. Vincent's Hospital Manhattan in Greenwich Village. "We just think there's an even better direction we'd like to try, or a combination of directions."...


http://www.nytimes.com/2005/06/06/nyregion/06hiv.html