Quantitative Rna Pcr And Genotyping
Quantitative RNA PCR must only be used to monitor HIV-positive individuals before or during antiretroviral therapy. It is used in conjunction with CD4 counts and general clinical assessments to ascertain when therapy should be started. It is also used to help determine the patient’s response to therapy. Genotyping is used to monitor the development or presence of drug resistance in patients before or during therapy. It is also used to assist physicians in their choice of antiretroviral drug combinations for the patient .
Quantitative PCR should not be used as a diagnostic test for HIV because false positives and false negatives can occur in these circumstances.
POC:
POC testing is testing carried out wherever the patient is located – in a clinic, hospital or doctor’s office. The use of such testing varies across Canada, with some provinces not using it at all and others using it extensively in sexually transmitted infection clinics or hospitals and as a preliminary screen for needlestick exposures in a health care setting . At an HIV consensus meeting in May of 2002 , a consensus statement was drawn up to address the use of POC tests. The basic recommendations are as follows:
What Are The Treatments For Hiv/aids
There is no cure for HIV infection, but it can be treated with medicines. This is called antiretroviral therapy . ART can make HIV infection a manageable chronic condition. It also reduces the risk of spreading the virus to others.
Most people with HIV live long and healthy lives if they get and stay on ART. It’s also important to take care of yourself. Making sure that you have the support you need, living a healthy lifestyle, and getting regular medical care can help you enjoy a better quality of life.
Where To Get Tested
Where you get tested for HIV depends on whatâs available in your area, how much you can spend, and your preferences. Among the places that offer testing are:
- Health clinics and community health centers
- County health departments
- STD and sexual health clinics
- Family planning clinics
- Substance abuse treatment and prevention programs
- LGBTQ+ health centers
- Private doctorsâ offices
Testing through local health departments and college health centers is often free. Some nonprofits also offer free or low-cost testing.
If you test positive, these organizations can help you get treatment. If you test negative, they can tell you about ways to prevent HIV infection.
At-home testing kits are available online and at pharmacies without a prescription. They generally offer you access to telephone counseling before and after testing.
To find out where you can get tested, check hiv.gov or gettested.cdc.gov, or call 800-CDC-INFO .
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What Is Hiv Testing
HIV testing, also called HIV screening, is the only way to know if you have the virus.
Several types of tests check your blood or other body fluids to see whether youre infected. Most cant spot HIV right away, because it takes time for your body to make antibodies or for enough of the virus to grow inside you.
Is There Any Treatment Of A Cure For Hiv/aids
Currently, there is no cure for HIV/AIDS. People living with HIV will need lifelong treatment. The best treatments right now are combinations of prescription drugs. These medications include antiviral treatment, protease inhibitors and other drugs that help people who are living with HIV stay healthy. People living with HIV also can stay healthy by doing things like eating properly, exercising and getting enough sleep.
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What Is Hiv What Is Aids
HIV is a virus that attacks the immune system, the bodys natural defense system. Without a strong immune system, the body has trouble fighting off disease. Both the virus and the infection it causes are called HIV.
White blood cells are an important part of the immune system. HIV invades and destroys certain white blood cells called CD4+ cells. If too many CD4+ cells are destroyed, the body can no longer defend itself against infection.
The last stage of HIV infection is AIDS . People with AIDS have a low number of CD4+ cells and get infections or cancers that rarely occur in healthy people. These can be deadly.
Having HIV does not mean you have AIDS. Even without treatment, it takes a long time for HIV to progress to AIDSusually 10 to 12 years. If HIV is diagnosed before it becomes AIDS, medicines can slow or stop the damage to the immune system. With treatment, many people with HIV are able to live long and active lives.
Laboratory Methods For Diagnosis Of Hiv Infection In Infants And Children
The definitive diagnosis of HIV infection at any age requires diagnostic testing that confirms the presence of HIV. Serological testing identifies HIV antigen and/or antibody generated as part of the immune response to infection with HIV. In children older than 18 months of age, serological testing should be used in the same manner as in adults. However, maternal HIV antibody is transferred to the baby passively during pregnancy and then declines . Infected infants then go on to produce HIV antibody however, most commonly used HIV serological assays cannot distinguish between maternal HIV antibody and HIV antibody produced by the infant, making the interpretation of reactive HIV serological test results difficult . In order to diagnose HIV infection definitely in children aged less than 18 months, assays are required that detect the virus or its components . A range of laboratory-based techniques are available, and these are discussed in more detail in the following section.
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Characteristics Of An Ideal Screening Test
The principles that define a good screening test are not unique to HIV infection but apply to medical screening in general. An ideal screening test will accurately identify individuals with the clinical condition of interest, without mistakenly diagnosing individuals who do not have the condition. In addition, use of screening tests is most effective when limited to conditions for which there is available, effective treatment that can directly target the disease and improve prognosis and outcomes.
Hiv Counseling And Testing
HIV Counseling and Testing is recommended for HIV testing programs targeting persons at increased risk for HIV infection. These programs are expected to identify confirmed HIV-positive persons at a rate of 1% or higher of persons tested. This rate is approximately ten times higher than, for example, the rate of confirmed HIV found in routine testing for all pregnant women in Illinois. In addition to testing, HIV Counseling and Testing includes an individual risk assessment to, identify HIV exposure risk behaviors and the circumstances that typically enhance or reduce risk, safer behavior goals and action steps to help reduce risk, and referrals to support risk reduction. For a list of funded counseling and testing providers in Illinois, see Resources in the right-hand column and click on HIV/AIDS Counseling and Testing Sites.
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Clinical Laboratory Improvement Amendments Criteria
With a range of HIV diagnostic tests now available, the testing process can occur in a wide range of clinical and nonclinical settings. Most HIV testing is performed in a laboratory setting and the time required to perform the tests varies significantly, but some laboratory tests can be performed in less than an hour. Several point-of-care, single-use rapid tests are now available that can be performed in clinical or nonclinical settings. In the United States, the Centers for Medicare and Medicaid Services regulates all clinical laboratory testing through the Clinical Laboratory Improvement Amendments . As part of this process, CLIA has established a three-level test complexity criteria and this applies to the different HIV testing procedures:
- Waived: These tests are considered simple to perform, low-risk, and can be performed with minimal training specimens do not require centrifugation for testing.
- Moderate Complexity: Although these tests are considered simple to perform the testing involves using plasma or serum specimens, and program participation in an external proficiency testing program.
- High Complexity: These tests involve multiple-step protocols and require trained laboratory personnel to perform, participation in an external proficiency testing program, and frequent checks on quality control.
How Do I Take Care Of Myself With Hiv
The best way to take care of yourself while living with HIV is to follow your treatment plan.
- Make sure to take your medications as prescribed and on time.
- Show up to all appointments so your healthcare team can monitor how youre feeling and know if theres a need to adjust your treatment.
- Follow your healthcare providers recommendations on how to avoid additional illnesses.
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Patient Population Under Consideration
This recommendation applies to adolescents, adults, and all pregnant persons regardless of age. Based on the age-stratified incidence of HIV infection and data on sexual activity in youth, the USPSTF recommends screening for HIV infection beginning at age 15 years. Adolescents younger than 15 years and adults older than 65 years should be screened if they have risk factors for HIV infection.
What Is A Window Period
Every HIV test has a different âwindow period.â Thatâs how long you need to wait after exposure until you can expect an accurate result. No HIV test can tell if you have the virus just after youâve been exposed.
If you get tested too soon, you may get faulty results. But if you wait too long to learn if youâre HIV-positive, you can miss out on early treatment and also unknowingly spread the virus to others.
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Confirming A Preliminary Positive Result
Because rapid HIV tests will sometimes give a False Positive, a reactive result when HIV infection has not actually occurred, a rapid test Preliminary Positive must always be confirmed by 1 or more supplemental laboratory tests. Your healthcare provider or HIV testing program will collect a follow-up sample for testing whenever a rapid test comes gives a reactive result.
Interpretation Of Serological Test Results
Negative HIV serological testing in an infant, following nationally validated testing algorithms, suggests the following:
- The infant is not HIV-exposed or
- The infant is HIV-exposed but has seroreverted or
- If the infant has never been breastfed or not breastfed in the past 6 weeks, the infant is HIV uninfected.
If the infant is still breastfeeding, a negative HIV serological test result cannot exclude HIV infection.
Positive or reactive HIV serological testing in an infant suggests the following:
- The infant is HIV-exposed and /or
- The infant may be HIV-infected the older the infant, the more likely the infant is of being HIV-infected.
For the purposes of testing in children in relation to breastfeeding, the window period required before serological testing can be reliably interpreted after cessation of breastfeeding using rapid tests or EIA is recommended to be 6 weeks. Isolated case reports of false-negative rapid HIV tests in sick children who then go on to being HIV-infected need to be investigated.
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The Complete Blood Count
The most common laboratory test is the complete blood count . It examines the components of blood, including red and white blood cells and platelets. Most test results are reported as amounts in a sample of blood or as a percentage. Other laboratory tests are discussed in Fact Sheet 122 and Fact Sheet 123.
All blood cells are made in the bone marrow, the center of large bones. Some medications or diseases can damage the bone marrow. This can reduce the numbers of different types of red or white blood cells.
Every laboratory has its own reference range or normal values for the results of each test. Most lab reports show the normal range and highlight any test results outside the normal range.
For more information on laboratory test results, see Fact Sheet 120 or Lab Tests online at
How Is Hiv Diagnosed
The U.S. Food and Drug Administration has approved tests that detect HIV antibodies in urine, fluid from the mouth , or blood. If a test on urine or oral fluid shows that you are infected with HIV, you will probably need a blood test to confirm the results. If you have been exposed to HIV, your immune system will make antibodies to try to destroy the virus. Blood tests can find these antibodies in your blood.
Most doctors use a screening blood test. If the screening is positive , the blood sample is tested again to verify the result. If the second test is positive, a test called a Western blot is performed for further confirmation.
It may take as long as six months for HIV antibodies to show up in a blood sample. If you think you have been exposed to HIV but you test negative for it:
- Get tested again in six months to be sure you are not infected.
- Meanwhile, take steps to prevent the spread of the virus. If you are infected, you can still pass HIV to another person at this time.
Some people are afraid to be tested for HIV. But if there is any chance you could be infected, it is very important to find out. HIV can be treated. Getting early treatment can slow down the virus and help you stay healthy. And you need to know if you are infected so you can prevent spreading the infection to other people.
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Timing Of Serological Testing In Infants
The most recent advances in EIA technology have produced combination assays, which allow for the simultaneous detection of p24 HIV antigen and HIV antibodies. This approach has further shortened the window period, i.e. the interval between HIV infection and detectable HIV antigen/antibodies. Rapid tests appear to offer similar performance characteristics but they detect antibody 28 days later than third-generation EIAs.
All children born to HIV-infected mothers carry detectable maternal HIV antibody and this declines slowly over the first year of life. The rate of decay of maternal antibody has been ascertained largely by analysis of studies to detect HIV antibody in children who have not been breastfed. The mean and/or median age at the time of seroreversion ranges between 9 and 16 months of age in studies from both developed and developing countries . These data indicate that maternal antibody may remain detectable through the first 6 months of life but significant decay occurs by 912 months of age. Most HIV-uninfected children do not have detectable antibody at 12 months of age .
Diagnosis Of Hiv In Infants And Children
HIV can be diagnosed definitively by virologic testing in most non-breastfed infants with perinatal HIV exposure by age 1 to 2 months and in almost all infants with HIV by age 4 to 6 months. Antibody tests, including the antigen/antibody combination immunoassays , do not establish the presence of HIV in infants because of transplacental transfer of maternal HIV antibodies therefore, a virologic test must be used.1,2 Positive virologic tests indicate likely HIV infection. Plasma HIV RNA or cell-associated HIV DNA NATs are generally equally recommended. However, both tests can be affected by maternal antiretroviral therapy through transplacental transfer of antiretroviral drugs from the pregnant person to fetus or by ARV drugs administered to the infant as prophylaxis or presumptive HIV therapy. In contrast, qualitative HIV proviral DNA PCR assays from whole blood detecting cell-associated virus often are less affected by ARVs.
An infant who has a positive HIV antibody test but whose mothers HIV status is unknown should be assumed to have been exposed to HIV. The infant should undergo HIV diagnostic testing, as described in Timing of Diagnostic Testing in Infants with Perinatal HIV Exposure below,15 and receive ARV prophylaxis or presumptive HIV therapy as soon as possible. For ARV management of newborns who have been exposed to HIV and newborns with HIV infection , see Antiretroviral Management of Newborns with Perinatal HIV Exposure or Perinatal HIV.
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Understanding Your Lab Work
In order for your health care team to know how best to care for you and manage your HIV, blood tests are done on a regular basis. With todays effective and well-tolerated antiretroviral treatments, people living with HIV no longer require monitoring as often as they used to. But its still important to get the recommended tests to keep tabs on your overall health and make sure your treatment is still working well. Here are the tests you will need:
VIRAL LOAD TEST
This test measures the number of copies of HIV genetic material in a small amount of blood. Two types of HIV genetic material may be measured, RNA or DNA. RNA tests are usually used for routine blood monitoring, but DNA tests can sometimes detect hidden HIV even if an RNA test is undetectable.
There is no normal range for viral loadthe point of HIV treatment is to keep it as low as possible for as long as possible. Standard HIV RNA viral loads tests usually can measure down to 50 or sometimes 20 copies. If your result comes back not detected or undetectable, your viral load is very low, known as viral suppression. Some tests used for research are more sensitive and can measure down to a single copy.
Once a person is on treatment and has achieved viral suppression, viral load can rise again for a few reasons.
Heres what a viral load test report looks like:
HIV-1 RNA
Log Copies/ML
CD4 CELL COUNT
T-cells are divided into three groups:
CD3 Absolute Count
CD3 Percentage
CD4 Cell Count
CD4 Percentage
CHEM SCREEN
Can I Get Pregnant If I Have Hiv
Some people think that HIV hurts your chances of getting pregnant, but this isnt true. If you have HIV and want to become pregnant, talk to your healthcare provider. Together you can make a plan before you try to get pregnant to keep you, your partner and any future children healthy.
HIV can spread to your partner during unprotected sex and to your baby during pregnancy, childbirth and breastfeeding. Taking ART medications can greatly reduce your risk of transmitting HIV to your baby, especially if you have an undetectable viral load. Your provider may recommend that you dont breastfeed your baby and use formula instead.
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