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What is Human Immunodeficiency Virus (HIV) test? 

Human immunodeficiency virus or simply HIV is the causative organism of acquired immune deficiency syndrome (AIDS), a sexually transmitted disease that leads to suppression of the immune system, making the person prone to opportunistic pathogens.
There are two types of HIV: 

  • HIV-1: Present globally
  • HIV-2: Predominantly found in Western Africa. Presently, HIV-2 has spread to the United States also. 

About 20% of the individuals infected with this virus are unaware of it because it does not show any symptoms.
Timely diagnosis of this virus helps in initiating therapy in the early stages and preventing the spread of the virus. Therefore, routine HIV testing can help in managing this disease.

An HIV test, also known as HIV screening, HIV screening test or HIV confirmatory test, is done to detect the presence of HIV in blood, saliva or urine.

Different types of HIV tests exist, which help identify the presence or absence of HIV in the blood and other body fluids. However, many of these tests do not recognise the presence of an active infection, as it takes a long time for the body to produce enough antibodies to fight against HIV. The three main types of HIV tests include:

  • Antibody test: It is performed on a blood or saliva sample to detect the presence of antibodies, a type of protein produced by the body to fight against foreign material, such as HIV, entering and attacking the body
  • Combined test: It is used to detect the presence of HIV as well as the antibodies produced against HIV in blood. This test can help diagnose HIV infection much earlier than an antibody test
  • The nucleic acid test: This test helps detect the presence or absence of HIV in blood and is suitable only after 7-28 days of infection
  1. Why is an HIV test performed?
  2. How do you prepare for an HIV test?
  3. How is an HIV test performed?
  4. What do HIV test results indicate?

An HIV test is performed to ensure the presence or absence of HIV. The Center for Disease Control and Prevention (CDC) insists that individuals aged 13-64 years should undergo an HIV test at least once as a part of their routine health check-up. Individuals at a higher risk should undergo the test more often. According to the CDC, individuals involved in the following are considered at a higher risk:

  • Men having sex with men
  • Sex for drugs or money
  • Intercourse with a partner with HIV
  • Multiple sex partners
  • Involvement in drugs and sharing of needles 
  • Sex with a partner who has experienced any of the above
  • Apart from individuals who are diagnosed or treated for tuberculosis, hepatitis or sexually transmitted disease are also at a high risk of HIV and should get themselves tested at least once in a year

HIV test is also advised to:

  • Pregnant women (they should know to protect themselves and the baby from such infections)
  • Couples before having sex for the first time
  • People who donate blood

Individuals experiencing the following symptoms may also undergo an HIV test:

No special preparations are needed before this test. However, ensure to inform the doctor about any herbs, medicines, vitamins or nutritional supplements, in case you are taking any, before the test as they may affect test results. Before the test is performed, the doctor may provide the following information associated with it:

  • The details of the test and procedure 
  • The details of AIDS and routes through which the virus spreads
  • Methods of prevention
  • Confidentiality of test results

An HIV test can be performed on blood or saliva samples. In the case of blood testing, blood will be collected from a vein in your arm or hands using a sterile needle.
For saliva sample collection, the healthcare provider will use a special swab and rub it against your gums.
Some risks associated with blood sample collection include infection, bruising, bleeding and lightheadedness. You may experience slight pain, sting and pricking sensation during the test. Also, soreness may be observed at the site of injection after the test is performed. Though most of these symptoms are temporary and will disappear quickly.

Normal results: A negative result is considered a normal result. It indicates the absence of HIV infection. However, a negative result does not ensure that the individual is not infected. This is because of the window period, the period between possible contact and the appropriate time for testing of HIV. HIV-antibodies appear in the blood only after the window period is over. The window period is variable for different individual and varies with the type of HIV. So, HIV test results may be falsely negative if the individual is tested before the completion of this period.
To ensure that the results obtained are correct, it is best to conduct this test after the window period is over. 

Abnormal results: Positive HIV test results are considered abnormal. Several additional tests are performed to ensure and confirm the diagnosis in such a case.
In the case of abnormal results, the treatment should be initiated immediately.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor. 

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HIV - 1 RNA Qualitative PCR

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HIV 1 And 2 Western Blot

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References

  1. Cleveland Clinic [Internet]. Cleveland, Ohio. AIDS & HIV: Diagnosis and Tests
  2. Cleveland Clinic [Internet]. Cleveland, Ohio. HIV Testing
  3. Cleveland Clinic [Internet]. Cleveland, Ohio. HIV Screening
  4. Moyer VA. Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement.. Ann Intern Med. 2013 Jul 2;159(1):51-60. PMID: 23698354
  5. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; Testing
  6. University of Rochester Medical Center. HIV-1/HIV-2 Rapid Screen. Rochester, New York. [internet].