The Cost-effectiveness of Voluntary Counseling and Testina of Hospital Patients for HIV

To the Editor.  —We are concerned that readers of the article about the cost-effectiveness of HIV counseling and testing of hospital inpatients by Dr Lurie and colleagues¹ might misinterpret the purposes of the CDC recommendations for voluntary counseling and testing of inpatients.² In addition, we believe that Lurie et al underestimate the cost-effectiveness of the CDC recommendations and overestimate the rate of false-positive HIV test results that would occur with large-scale testing.Although Lurie et al refer to the purpose of CDC recommendations for voluntary counseling and testing of hospital patients, we would like to reiterate that CDC recommendations state that HIV testing programs must not be used as a substitute for universal precautions and other infection control techniques.² The purpose of the recommendations was not to decrease transmission to health care workers; rather, their purposes were to assist in the differential diagnosis of medical conditions, to