How Likely Is It To Spread Around The World
So far, the majority of confirmed cases have been in South Africa, with a handful in Botswana and Hong Kong. A further case was detected on Thursday evening in Israel an individual who had returned from Malawi and two other cases are suspected in the country. On Friday, Belgium confirmed it had detected a case in someone who had travelled to Egypt and Turkey.
Nevertheless, given that there is community transmission in southern Africa, if there is a transmissibility advantage the new variant is likely to have already spread undetected to other countries.
Discusses Physiology Pathophysiology And General Clinical Aspects As They Relate To A Laboratory Test
Currently, 2 types of HIV, HIV type 1 and HIV type 2 , are known to infect humans. HIV-1 has been isolated from patients with AIDS, AIDS-related complex, and asymptomatic infected individuals at high-risk for AIDS. Accounting for more than 99% of HIV infection in the world, HIV-1 is transmitted by sexual contact, by exposure to infected blood or blood products, from an infected pregnant woman to fetus in utero or during birth, or from an infected mother to infant via breast-feeding. HIV-2 has been isolated from infected patients in West Africa and it appears to be endemic only in that region. However, HIV-2 also has been identified in individuals who have lived in West Africa or had sexual relations with individuals from that geographic region. HIV-2 is similar to HIV-1 in its morphology, overall genomic structure, and ability to cause AIDS.
Multiple clinical studies of plasma HIV-1 viral load have shown a clear relationship of HIV-1 RNA copy number to stage of HIV-1 disease and efficacy of anti-HIV-1 therapy. Quantitative HIV-1 RNA level in plasma is an important surrogate marker in assessing the risk of disease progression and monitoring response to anti-HIV-1 drug therapy in the routine medical care of individuals living with HIV-1.
Appendix : Different Types Of Hiv Test
Different HIV tests work by looking for three different things.
In this section we describe the main HIV tests.
- Antigen only . These are rarely used.
- Antibody only tests . These are rarely used because of more recent availablilty of joint Ag/Ab tests.
- Combined antibody-antigen tests. These are the most commonly recommended tests in the UK. these test for p24 plus antibodies.
- Viral load tests
More details about how the tests work and the science behind them is included in Appendix 3.
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Why Might People Living With Hiv Get Tested For Hiv
Because we connect with every single person who tests positive at one of our locations, we always ask why people get tested for HIV if theyve already been diagnosed in the past.
It happens for many reasons: People may test with a partner they havent yet disclosed to, they may have mental health concerns that come into play, or they need a letter of diagnosis to access services . Sometimes its because they are confused about the kind of information an HIV test will provide.
Now that weknow undetectable equals untransmittable , some people may have the misconception thatif youre undetectable, you will no longer test positive for HIV. They may think that if they test HIV-negative on an HIV test, theyll be able to show this to their sex partners as a way to prove that theyre undetectable and untransmittable. Or, they may think it will be easier to tell partners theyre HIV-negative rather than undetectable and uninfectious.
If you are living with HIV and have an undetectable viral load, you will still test positive for HIV. But, if you are living with HIV, have been taking HIV medications every day as directed, have a durably suppressed viral load and have been undetectable for at least six months, you will not transmit HIV to sex partners. You are not infectious. Thats the meaning of U=U.
Heres why you will still test positive for HIV even if you are undetectable.
Will Existing Vaccines Work Against It
Scientists are concerned by the number of mutations and the fact some of them have already been linked to an ability to evade existing immune protection. These are theoretical predictions, though, and studies are rapidly being conducted to test how effectively antibodies neutralise the new variant. Real-world data on reinfection rates will also give a clearer indication on the extent of any change in immunity.
Scientists do not expect that the variant will be entirely unrecognisable to existing antibodies, just that current vaccines may give less protection. So a crucial objective remains to increase vaccination rates, including third doses for at-risk groups.
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Confirmation Of Hiv Infection
Patients who have been tested and found to be HIV positive are regularly referred from various primary and secondary hospitals, as well stand-alone HCT centers, to the UCH ART clinic for management. HIV infection status of the patients was confirmed by Western Immunoblot , a qualitative immunoblot assay with a nitrocellulose membrane containing 8 HIV-1 proteins and a recombinant HIV-2 specific envelope antigen . Briefly, the nitrocellulose strip containing the HIV-1 and 2 proteins were reacted with 10 L of serum/plasma specimen and washed to remove unbound antibody. Human immunoglobulin specifically bound to HIV-1 or HIV-2 proteins/antigen is visualized after reaction with goat antihuman immunoglobulin-alkaline phosphatase conjugate and BCIP/NBT substrate. The bands on the test strips are identified by comparing them to the bands on the positive control strip and results interpreted as follows: No band present , any two or more of the following bands present: p24, gp41, gp120/gp160 , any band pattern not matching the criteria for positive HIV-1 result , HIV-2 band present . Only individuals with positive Western blot results were pre-assessed for ART initiation.
What Will Being Undetectable Mean For Me
Having an undetectable viral load means that your ART is effectively controlling your HIV. This will protect your immune system and help you to stay in good health.
Being undetectable also means that you dont have to worry about passing HIV onto your sexual partners. For many people this is just as important to them, giving them relief from the anxiety of passing HIV on. Some people find that knowing theyre undetectable makes it easier to with others, as it can be reassuring for others to know that your health is protected and you cant pass it on too.
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Why Do I Need An Hiv Test
The Centers for Disease Control and Prevention recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care. You may also need an HIV test if you are at higher risk for infection. HIV is mainly spread through sexual contact and blood, so you may be at a higher risk for HIV if you:
- Are a man that has had sex with another man
- Have had sex with an HIV-infected partner
- Have had multiple sex partners
- Have injected drugs, such as heroin, or shared drug needles with someone else
HIV can spread from mother to child during birth and through breast milk, so if you are pregnant your doctor may order an HIV test. There are medicines you can take during pregnancy and delivery to greatly reduce your risk of spreading the disease to your baby.
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What Does A Positive Hiv Test Result Mean
If you have a positive HIV test result, a follow-up test will be conducted. If the follow-up test is also positive, it means you are HIV-positive.
If you had a rapid screening test, the testing site will arrange a follow-up test to make sure the screening test result was correct. If you used a self-testing kit at home, a positive HIV test result must always be confirmed by additional HIV testing performed in a health care setting. If your blood was tested in a lab, the lab will conduct a follow-up test on the same sample.
If your follow-up test result confirms you are infected with HIV, the next thing is to take steps to protect your health and prevent transmission to others. Begin by talking to your health care provider about antiretroviral therapy . ART is the use of HIV medicines to treat HIV infection. People on ART take a combination of HIV medicines every day. ART can keep you healthy for many years and greatly reduces your chance of transmitting HIV to your sex partner if taken the right way, every day. Your health care provider will help you decide what HIV medicines to take.
If you have health insurance, your insurer is required to cover some medicines used to treat HIV. If you dont have health insurance, or you need help because your insurance doesnt pay for the treatment you need, there are Federal resources that may help you.
To lower your risk of transmitting HIV,
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If You Have A Negative Test Result Does That Mean That Your Partner Is Hiv
No. Your HIV test result reveals only your HIV status.
HIV is not necessarily transmitted every time you have sex. Therefore, taking an HIV test is not a way to find out if your partner is infected.
It’s important to be open with your partner and ask them to tell you their HIV status. But keep in mind that your partner may not know or may be wrong about their status, and some may not tell you if they have HIV even if they know they’re infected. Consider getting tested together so you can both know your HIV status and take steps to keep yourselves healthy.
Preparation Prior To Transport
Label the specimen container with the patients full name, date of collection and one other unique identifier such as the patients date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.Place specimen in a biohazard bag and seal. It is recommended to ship specimens for testing to PHO Laboratory immediately after collection or processing to avoid delays in testing. Whole blood that has not been centrifuged must be received at PHO Laboratory within 24 hours of collection, before 2:00 p.m. Monday – Friday. Plasma stored at 2°C – 8°C must be shipped with ice packs within 6 days of separation. Frozen plasma must be shipped on dry ice.Shipping of specimens shall be done by TDG certified individuals in accordance with TDG regulations.
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Age Acceleration Effects Due To Hiv
Infection with the Human Immunodeficiency Virus-1 is associated with clinical symptoms of accelerated aging, as evidenced by increased incidence and diversity of age-related illnesses at relatively young ages. A significant age acceleration effect could be detected in brain and blood tissue due to HIV-1 infectionwith the help of a biomarker of aging, which is known as epigenetic clock.
When Can Each Test Be Used
Viral load can sometimes be detected within a week, p24 on average by day 16 and antibodies by day 25. However, these are average results a lot of people take longer.
A test that misses half of infections is not very useful.
So a 4th generation antigen/antibody test is recommend four weeks after exposure because it will detect 95% of infections.
Validating the timing of viral load , p24 and antibodies is difficult. Tests can only be checked against blood samples from the same people before and after infection. These are usually people who regularly donate blood .
Some of these people catch HIV without knowing it. When this picked up in blood screening, these samples are used for testing new HIV tests.
This is why it is impossible to give the percentage chance that a test will be accurate for each day. The tests have been checked on a limited number of samples. These sample reflect the large range of individual responses.
On average, viral load tests with a cut-off of 50 copies/mL detect infection about 7 days before a p24 antigen test and 12 days before an antibody test.
These relative times are only used when comparing new tests. They are not good at setting an absolute cut off at 14 days or 19 or 41 days etc.
Figure 13 shows the time ranges after an exposure. Very rarely an antibody response may take longer. Even more rarely an infection may not make antibodies. These people have positive viral RNA and DNA.
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Who Can Be Tested With The Hiv Rna Test
- Anyone who is known to have potential Exposure to HIV-1 in the past 12 weeks thru
- Unprotected sex
- High risk behavior by sharing non-sterile needles
- Exposure to HIV infected blood
When To Get A Test
Right after you’re diagnosed, you should get a viral load test for a “baseline measurement.” That gives your doctor something to compare future test results to.
When you start or change medicine, a test about 4 weeks afterwards helps your doctor decide how well it’s working. An effective drug combination, taken as prescribed, can often drop the HIV viral load to one-tenth of what it was within a month. The viral load is generally undetectable by 3 months, nearly always by 6 months.
After that, you should get a test as often as your doctor recommends to see how your medications are controlling the virus. If your HIV seems to be under control, you can probably be tested less frequently.
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Is It More Transmissible
This is not yet clearcut but the emerging picture is worrying. There has been a surge of cases in South Africa from 273 cases on 16 November to more than 1,200 by the start of this week. More than 80% of these were from Gauteng province and preliminary analysis suggests the variant has rapidly become the dominant strain. The R value, which indicates how fast an epidemic is growing, is estimated to be 1.47 for South Africa as a whole, but 1.93 in Gauteng. There is a chance this is a statistical blip linked to a super-spreader event but the data has triggered enough concern for precautionary measures.
Testing Process For Hiv Rna
The testing process for HIV RNA is convenient and simple. If you are looking to be tested, then follow the steps below.
- Locate your testing center close to you by entering in your zip code.
- Fill out the form with your information and make your payment.
- You will get an email that has a Lab Requisition Form that has a testing code. The address of your testing center will also be included.
- Print out the form and testing code and take it to the testing center.
- Get tested in just 5 minutes using a small blood sample.
- You will receive your results in 1-2 days.
- If your test is positive, you will have a consultation with a doctor over the phone.
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How Much Does The Test Cost
The cost of HIV viral load testing depends on where a patient has the test conducted and whether they have health insurance. Additionally, laboratory and other charges vary. Patients should discuss the costs of testing with their doctor, the laboratory, and/or their health insurance provider.
If paying for HIV testing and treatment is a concern, resources are available to help people with HIV gain access to medical care through the US Department of Health and Human Services: How to Find HIV Treatment Services.
Hiv Rna Test Compared To Other Tests
The HIV RNA test is a type of nucleic acid test . NATs are blood tests used to detect the genetic material of viruses and bacteria in your blood. Theyre sometimes used to screen blood donations for HIV and other conditions, such as hepatitis B.
The HIV RNA test is also called the HIV viral load test, since it can identify the viral load, or how much genetic material from HIV is in your blood. This sets it apart from other HIV tests.
According to the , there are two other types of HIV tests:
- HIV antibody tests. These tests look for antibodies created by your body in response to HIV.
- HIV antigen/antibody tests. These tests look for antibodies, but they also look for antibodies and an HIV protein called p24.
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How An Hiv Rna Test Is Done
Since the HIV RNA test is a blood test, theres no special way to prepare for it. But some people find that being well hydrated before any type of blood test makes it easier for the technician to find a vein.
A technician will swab your arm with an antiseptic wipe or solution. Then, a blood sample will be drawn from a vein in your arm.
Based upon the lab used, it may take up to 10 days for you to get the results of your test.
Questions For Your Doctor About Test Results
It may be helpful to gather questions for the doctor about a patients HIV viral load results. Questions to learn more about test results may include:
- What is my HIV viral load?
- How does this test result compare to previous results?
- Do I need any treatment or a change in treatment based on my results?
- How can I talk to my sexual partners about HIV?
- When should I be tested for STDs and how often?