HIV Tests and The Essentials In It

HIV test is a screening procedure to detect HIV infection in the body somebody. Test this need done regularly, whether at risk or not, so that HIV infection can indetection and handled since early stage.

HIV or human immunodeficiency virus is a virus that destroys the cells of the immune system that protect the body from disease. So when the number of these cells is reduced due to damage, the body will be susceptible to infections and other diseases.

HIV infection is a dangerous disease that can even cause death. Therefore, HIV testing is recommended to be carried out routinely by everyone, especially those who are at risk of developing this disease.

With regular HIV testing, HIV infection can be detected early, so that someone diagnosed with HIV can immediately start treatment and make changes in behavior and lifestyle. The sooner HIV infection is treated, the better the control of the virus in the body.

HIV Test Indications

HIV testing should be carried out by every individual, especially those between the ages of 13–64 years, who need to have an HIV test as part of a routine health check. Apart from being a routine checkup, doctors can also recommend HIV testing for someone with the following conditions:

  • Have signs or symptoms that suggest HIV infection, such as opportunistic infections
  • Diagnosed with certain health conditions, such as sexually transmitted diseases, hepatitis B or C, tuberculosis, or lymphoma
  • Frequently changing partners, having free sex, and having unprotected sex
  • Having sex with the same sex
  • Using drugs by injection or infusion, and sharing syringes
  • Is pregnant
  • Babies born to women with HIV
  • Receiving blood transfusions regularly, for example due to suffering from thalassemia

Doctors also recommend that HIV tests be carried out more regularly every 3 or 6 months in people who are at high risk of exposure to the HIV virus, such as partners with HIV, sexually active homosexuals, and commercial sex workers.

HIV Test Alert

There are several things that can affect the results of an HIV test, including:

  • Run the test while still in the window period (window period), i.e. when antibodies to HIV have not been formed
  • Suffering from health problems, such as autoimmune disease, leukemia, or syphilis
  • Recent vaccinations
  • Taking corticosteroid drugs
  • Consuming too much alcohol

The above conditions can make the HIV test result positive even though the patient is not infected with HIV (false positive), or vice versa, the test result is negative even though the patient is infected with HIV (false negative).

Before HIV Test

Generally, patients do not require special preparation to undergo an HIV test. However, the doctor may conduct a counseling session before and after the test to discuss some of the following:

  • HIV test procedures to be performed, interpretation of test results, and other types of tests that may be performed
  • Diagnosis of HIV infection that can affect the patient's social, emotional, professional and financial outlook
  • Various benefits of early diagnosis and treatment

It is important to tell the doctor how and where the doctor can contact the patient when the test results come out.

In addition, there are several conditions that patients need to inform their doctors about before undergoing an HIV test if they have them. This aims to reduce the risk of side effects after the test. These conditions are:

  • Easy bruising
  • Bleeding disorders, such as hemophilia

Apart from the two conditions above, patients should also tell their doctor before undergoing an HIV test if they are taking blood thinners or anticoagulants, such as aspirin and warfarin.

Types of HIV Test

There are various types of HIV testing. However, no HIV test is perfect. Therefore, it is sometimes necessary to perform several tests or repeat tests to confirm the diagnosis.

In general, there are three main types of HIV testing:

Antibody test

This type of HIV test is done to detect HIV antibodies in the blood. HIV antibodies are proteins produced by the immune system in response to HIV infection, usually 1–3 months after infection. Generally, this test is used for initial screening.

There are several types of antibody tests, namely:

  • ELISA (enzyme-linked immunosorbent assay)

    ELISA is done by inserting a blood sample into a container containing HIV antigen. If the blood contains HIV antibodies, the color of the blood will change.

  • Rapid HIV test

    Procedurally, rapid HIV test almost the same as ELISA. In fact, these tests tend to be easier to perform. The test results can be released on the same day. It's just that, even though the process is easy and the results come out quickly, rapid HIV test has a low level of accuracy, so it requires further tests.

Generally, HIV tests that detect HIV antibodies require further tests to confirm the test results. The follow-up test is called confirmatory assays.

Confirmatory assay This is done by using the antibody protein separation method extracted from blood cells. In addition to confirming test results, confirmatory assay also performed to distinguish the type of HIV virus, whether HIV-1 or HIV-2.

PCR test (polymerase chain reaction)

The PCR test is used to detect the genetic material (RNA or DNA) of HIV in the blood. Just like an antibody test, this test is done by taking a blood sample for further examination in a laboratory.

The PCR test is the most accurate HIV test. This test can even detect HIV infection even if the immune system has not yet produced antibodies against the virus. But unfortunately, this test is rarely used because it requires a large amount of money and a lot of time and effort.

The antibody-antigen combination test (Ab-Ag test)

Ab-Ag testt performed to detect HIV antigen known as p24 and/or HIV-1 or HIV-2 antibodies. Antigens can be found in the blood more quickly than antibodies. Therefore, this test can be used to detect HIV approximately 2–6 weeks after the estimated time of infection.

HIV Test Procedure

HIV testing is generally done through a blood sampling procedure, which takes less than 5 minutes. Blood sampling is usually done at the elbow crease. The following are the steps for taking a blood sample:

  • The doctor will tie the patient's upper arm with an elastic cord to block the blood flow, so that the veins around the band are more visible and easier to puncture.
  • The doctor will clean the area of ​​​​the skin that will be pricked with alcohol.
  • After the skin is cleaned, the doctor will insert a needle connected to a blood collection tube into the patient's vein.
  • After a sufficient amount of blood has been drawn, the doctor will remove the elastic from the patient's arm.
  • When the needle is removed, the patient will need to apply pressure to the injection site with cotton or alcohol gauze to stop the bleeding.
  • Then, the doctor will cover the injection area with a bandage or bandage.

HIV Test Results and After HIV Test

The blood sample that has been taken will be analyzed in the laboratory. Depending on the type of test performed, the results of an HIV test can come in a few days to a few weeks.

HIV test results can be negative, positive, or undetermined. Here's the explanation:

  • Negative

    An HIV test result can be said to be negative if no antibodies, antigen, or HIV genetic material are found in the patient's blood.

  • Positive

    In contrast to a negative result, an HIV test result can be said to be positive if HIV antibodies, antigens, or genetic material are found in the patient's blood.

  • Can not be determined (indeterminate result)

    If this occurs, a PCR test may be performed to confirm the diagnosis. Patients who continue to have inconclusive test results for 6 months or more are referred to as stable indeterminate and considered not infected with HIV.

If the HIV test result is negative, it does not mean that the patient is not infected with HIV. The patient may still be in the incubation period of the virus or in the window period (window period). The doctor will advise the patient to undergo a retest 3 months after the first test, especially if the patient is at risk for HIV infection.

If the HIV test is still negative, the patient is declared not infected with HIV. However, your doctor may recommend regular HIV tests to detect early if there is an HIV infection.

If the patient is tested positive for HIV infection, the doctor will carry out further tests, such as:

  • CD4 examination, which is an examination to count the number of immune cells called CD4 which can decrease due to HIV infection
  • viral load, which is an examination to calculate the amount of virus contained in the body

With these two follow-up examinations, doctors can determine and plan the right steps and types of treatment for patients.

In addition, there are several initial steps that doctors will recommend after a patient is diagnosed with HIV, namely:

  • Discuss with fellow HIV sufferers to help adapt to the conditions
  • Taking antiretroviral drugs (ART) to inhibit the development of HIV, protect the body's immune system, and reduce the risk of transmission to others
  • Undergo further examinations to detect and prevent the possibility of other sexually transmitted infections
  • Ask your partner to get tested for HIV
  • Using a condom when having sex with a partner

Side effects HIV test

The procedure for drawing blood for an HIV test is generally safe and rarely causes side effects. If present, the patient may experience only mild side effects, such as:

  • Dizziness or headache
  • A small bruise (hematoma) appears at the injection site
  • Arm feels sore and weak
  • Infection at the injection site