Agenda - Council - 06/25/1991 - Laserfiche WebLink

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164 MMWFI M~ch 14. 1986 /-/TL 1/./////.~4 I/- Cont/nue~ (7) Avoiding pregnancy until more is known about the risks of transmitting HTL¥-III/ I_AV from mother to fetus or newborn (8). (8) Cleaning end disinfecting surfaces on which blood or other body fluids have spitled, in.accordance with previous recommendations (2). (9) Informing physicians, dentists, and other appropriate health professionals of his/her antibody status when seeking medical care so that the patmnt can be ap- propriately evaluated. 3. Infected patients should be encouraged to refer sex partners or persons with whom they have shared needles to their health-care provider for evaluation and/or testing. If patients prefer, trained health department professionals should be made available to assist in notifying their partners and counseling them regarding evaluation and/or testing. 4. Persons with a negative test result should be counseled regarding their need for continued evaluation to monitor their infection status if they continue high-risk behavior (8). 5. State and local health officials should evaluate the implications of requiring the reporting of repeatedly reactive HTLV-III/LAV antibody test results to the state health department. 6. State or local action is appropriate on public health grounds to reg.utate or close.establish- ments where there is evidence that they facilitate high-risk behaviors, such as anonymous sexual contacts and/or intercourse with multiple partners or IV drug abuse (e.g., bath- houses, houses of prostitution. "shooting galleries"). TEST INTERPRETATION Commercially available tests to detect antibody to HTLV-III/LAV are enzyme-linked immu- nosorbant assays (ELISAs) using antigens derived from disrupted HTLV-III/LAV. When the ELISA is reactive on initial testing, it is standard procedure to repeat the test on the same specimen. Repeatedly reactive tests are highly sensitive and specific for HTLV-III/LAV anti- body. However. since falsely positive tests occur, and the implications of a positive test are serious, additional more specific tests (e.g.. Western blot. immunofluorescent assay, etc.) are recommended following repeatediy reactive ELISA results, especially in Iow-prevalence popu- lations. If additional more specific test results are not readily available, persons in high-risk groups with stron~ repeatedly reactive £LISA results can be counseled before any additional test results are received regarding their probable infection status, thmr need for medical follow-up° and ways to reduce further transmission of HTLVolII/LAV. OTHER CONSIDERATIONS Stat~ or local i;~l~clas governing informing ~ counseling sex partners and those who. share needles with persons who are HTLV-IIt/LAV-antibocly positive will vary, depending on state end local statutes that authorize s~:h actions, Accomplishing the objective of interrupt- lng tran~nission by encouraging testing and counseling among persons in high-risk groups will depend heavily on health officials paying careful attention to maintaining confidentiality end protecting records from unauthorized disclosure. The public health effectiveness of various approaches to counseling, sex-partner referral. and laboratory testing will require careful monitoring. The feasibility and efficacy of each of these measures should be evaluated by state end local health departments to best utilize available resources. ~v~tope~ by Cent~ fo~ P~eventi~n Svcs end CAnter t~ infectious Diseases, CDC. in consultation with Curren JVV. Morgan WM. Hardy AM, Jaffa HW. Dan'ow VVW. Dowdla WR. The epidemiotogy of AJDS: current statu,~ end future prospects. Science 1985;229:1352-7. 2. C3~)~. Recommendations fo~ pr~®nflng t~nsmiss~n o~ ~nfect-i.o~ w~th human T-~ymphotTopic virus Iype III/lymphadenopathy-associated virus in the workl~eCe. MMWR t 985;34:682-6. 691-5. 3, CDC. Update: acquired immunodefic~e~c¥ $¥nclrome in the San Francisco cohort study, 1978-1985. MMWR 1985;34:573-5.