Why Should Cd4/cd8 Ratio Be Used As A Marker In The Hiv Population
The natural history of untreated HIV infection has opposing effects on circulating CD4 and CD8 T lymphocytes. Before HIV lowers CD4 cells, circulating CD8 cells will typically rise in response to the infection, resulting in a low CD4/CD8 ratio . In the setting of ART, some patients will restore CD4 counts and experience a decline in CD8 counts, leading to normalization of the ratio. For other individuals, however, despite suppression of the virus and improvement of CD4 levels, the high levels of circulating CD8 cells are maintained, and their ratios fail to improve . A recent cross-sectional study of 334 of these virologically suppressed patients demonstrates that a lower CD4/CD8 ratio during treatment predicts residual HIV viremia , as detected by single-copy assay . Whether this residual viremia is a cause or effect of a lower CD4/CD8 ratio is unknown, but the association highlights the discordant immune activation and immune senescence in the virologically suppressed.
How Do I Get My Results
Depending on the type of test you take, you will have to wait either a few minutes for your results , or anywhere between a couple of days or weeks . Your healthcare professional should explain how you will get your test results. If you are self-testing, there will be information on how to read your results with your test kit.
If your result is negative, the health centre will contact you to let you know that you tested negative. All positive and will have to be checked again, so you will be asked to come back for further testing.If you get a positive result after using a self-test kit you will need to go to a healthcare clinic.
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,
Read Also: How To Find Out If Someone Has Hiv Aids
What Does It Mean To Be Durably Undetectable
Taking antiretroviral therapy daily as prescribed to suppress HIV levels leads to an undetectable status. A person is considered to have a durably undetectable viral load if their viral load remains undetectable for at least six months after their first undetectable test result. It is essential to continue to take every pill every day as directed to maintain an undetectable viral load.
Testing Positive On Nucleic Acid Tests
In addition to antibody tests, we also have HIV tests that detect viral RNA not necessarily live virus, but parts of the virus genetic material. These are called nucleic acid tests, and they are able to detect very early HIV infections. These tests are not used as often for screening as antibody tests , because results take longer and the test is more expensive. Usually, RNA tests are used to confirm an HIV positive diagnosis after someone tests positive on an antibody test or to see if a person is responding well to treatment.
Some of these viral detection tests are able to detect virus at very low levels. Some research HIV RNA assays can measure HIV RNA levels down to the single copy levels.
We commonly say someone is undetectable if they have a viral load less than 20 copies/mL or 50 copies/mL. Research studies have defined undetectable as any viral load less than 200 copies/mL.
So even if a person has a viral load less than 50 copies/mL or 20 copies/mL, viral RNA will still be detected with one of these viral detection tests.
Don’t Miss: Can You Get Hiv From Dried Blood
What Happens If I Stop Taking Antiretroviral Therapy
When therapy is stopped, viral load rebounds, and the risk of transmitting HIV to a sexual partner in the absence of other prevention methods returns. NIAID-supported research has provided clear-cut scientific evidence to support the benefits of staying on continuous antiretroviral treatment. In 2006, NIAIDs large clinical trial called SMART showed that people receiving intermittent antiretroviral treatment had twice the rate of disease progression compared to those receiving continuous treatment.
Taking antiretroviral treatment daily as directed to achieve and maintain durably undetectable status stops HIV infection from progressing, helping people living with HIV stay healthy and live longer, while offering the benefit of preventing sexual transmission. Stopping and re-starting treatment can cause drug resistance to develop, making that treatment regimen ineffective and limiting future treatment options.
What Is The Cd4/cd8 Ratio
CD4 helper/inducer cells and CD8 cytotoxic/suppressor cells are 2 phenotypes of T lymphocytes, characterized by distinct surface markers and functions that mostly reside in lymph nodes but also circulate in the blood. The normal CD4/CD8 ratio in healthy hosts is poorly defined. Ratios between 1.5 and 2.5 are generally considered normal however, a wide heterogeneity exists because sex, age, ethnicity, genetics, exposures, and infections may all impact the ratio . Normal ratios can invert through isolated apoptotic or targeted cell death of circulating CD4 cells, expansion of CD8 cells, or a combination of both phenomena. A low or inverted CD4/CD8 ratio is an immune risk phenotype and is associated with altered immune function, immune senescence, and chronic inflammation in both HIV-infected and uninfected populations .
Also Check: Hiv Causes Hair Loss
What Does The Presence Of Hiv Antibodies Indicate
If an HIV antibody test is negative, no antibodies were detected. A positive HIV antibody test means that the body has been exposed to HIV . A person with a positive HIV test will need to have further testing done to confirm this diagnosis.
In this regard, what does it mean to have HIV antibodies?
Antibodies are proteins produced by your body when you have an infection and they help fight infection. If you are infected with HIV, your body makes very specific antibodies to fight the infection. If you have HIV antibodies, then you have been infected with HIV.
Similarly, what antibodies are present in HIV? It detects the HIV antigen called p24 plus antibodies to HIV-1 and HIV-2. The level of p24 antigen and the amount of virus increase significantly soon after initial infection.
Besides, what does the presence of antibodies mean?
Autoantibodies are antibodies that mistakenly target and react with a person’s own tissues or organs. However, when the immune system ceases to recognize one or more of the body’s normal constituents as “self,” it may produce autoantibodies that react with its own cells, tissues, and/or organs.
Is it possible to have HIV antibodies and not have HIV?
Normal results are negative. This means that no antibodies were found and that you may not be infected with HIV. Most people who become infected with HIV will develop antibodies to the virus within 2 months. During this time, you may have HIV but this test can’t detect it.
You May Like Also
Who Will Know The Results Of My Testing
It depends on where you get your testing. Testing sites have different privacy rules. Ask about privacy rules at your testing site so you understand whether anyone else will know you got tested or see your results.
If you go to an anonymous test site, only you know the results. No written record of the test result is kept.
If you go to a confidential test site, the results will go in your medical record. Positive results are sent to the state or local health department. Your insurance company will have access to your results. Depending on the state you live in, your parent or guardian may be contacted.
Also Check: How Long Can Hiv Go Undetected
What Does A Negative Hiv Test Result Mean
A negative result doesn’t necessarily mean that you don’t have HIV. That’s because of the window periodthe time between when a person gets HIV and when a test can accurately detect it. The window period varies from person to person and is also different depending upon the type of HIV test.
Ask your health care provider about the window period for the kind of test youre taking. If youre using a home test, you can get that information from the materials included in the tests package. If you get an HIV test after a potential HIV exposure and the result is negative, get tested again after the window period for the test youre using to be sure. To learn more about the window period and when a person should get retested, see CDCs How soon after an exposure to HIV can an HIV test if I am infected?. If you get an HIV test within 3 months after a potential HIV exposure and the result is negative, get tested again in 3 more months to be sure.
If you learned you were HIV-negative the last time you were tested, you can only be sure youre still negative if you havent had a potential HIV exposure since your last test. If youre sexually active, continue to take actions to prevent HIV, like using condoms the right way every time you have sex and taking medicines to prevent HIV if youre at high risk.
False Negatives After The Window Period
After the window period, in people who arent taking antiretrovirals, false negative results are extremely rare.
The accuracy of a single HIV test depends in part on characteristics known as sensitivity and specificity. Sensitivity is an indication of test performance when testing people who do have HIV, whereas specificity reflects test performance in relation to people who do not have HIV. Many modern HIV testing devices are extremely sensitive and extremely specific in relation to long-standing HIV infection. Theres more information on sensitivity and specificity on another page.
To some extent, the chances of having a false negative result also depend on how common HIV is in your community. When very few people among those testing actually have HIV, it is even more likely that a negative HIV test result is accurate. This is expressed by something known to healthcare workers as the negative predictive value.
incidence
The proportion of people who acquire an infection or develop a condition during a specified period of time. Incidence reflects newly acquired infections and conditions. See also prevalence.
For example, take a test with 99.5% sensitivity and 99.5% specificity. If this test is used in a setting where 0.2% of people have HIV , the probability of a negative result being correct is 99.998%.
If the same test is used in a setting with a much higher HIV prevalence of 25% , the probability of a negative result being correct is marginally lower, at 99.832%.
Don’t Miss: Hiv 1 2 Antibodies
What Happens If My Test Is Positive
If you test positive for HIV, it is important to remember that with treatment you can live a long, healthy life. In fact, with early treatment, people with HIV can live about as long as people that are not infected.
A team approach will help you get the medical care and support that you need. Start by talking to your doctor or the counselor or social worker at the testing site. He or she can help you with suggestions on how to talk to your parents or guardians and how to find a health care provider who’s an HIV specialist. By starting treatment as soon as possible, you can stay healthy and learn to live well with HIV.
What Do Test Results Mean
Getting Tested
To understand what your test results mean, you first have to understand what kind of test is being used and what a “window period” is.
Most HIV screening tests look for HIV antigen or for HIV antibodies , or may look for both. Newer testing strategies use a combination antigen/antibody test. Some testing sites also use a test that looks for genetic material of the HIV virus.
The window period is the period between the time someone is first infected with the HIV virus and the time an HIV test can detect HIV infection. After someone has been infected with the virus it can take about 2 weeks for HIV antigen to be detectable with current antigen tests, and more than 3 weeks to produce enough HIV antibodies to be detected by antibody tests. In a very small number of people, the process takes up to several months.
During the window period, someone might be infected with HIV yet still have a negative result on an HIV test. Here’s how that can happen. Let’s say you have condomless sex on Saturday night and become infected with HIV. On Monday, you get an HIV test. The test almost certainly will come back negative, because there is not yet enough HIV antigen or HIV antibody for the tests to detect.
Newer methods of HIV testing are narrowing the time of the “window period” and reducing the chance of a falsely negative result.
When testing is completed, your provider will tell you the result. Possible results are:
You May Like: Does Hiv Cause Hair Loss
How Can I Get Tested
To get tested, you can:
- Ask your doctor to test you.
- Go to a local clinic or community health center.
- Go to National HIV and STD Testing Resources to find a testing center near you.
- Buy a test at a pharmacy and do the test at home.
Many testing centers will do an HIV test for free. Ask if there is a fee before you go for testing. In most states you do not need a parent’s permission to get tested for HIV. And you can buy the test at the pharmacy without a parent.
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.
Recommended Reading: Does Cookie Johnson Have Hiv
What Does A Reactive Test Result Mean
A reactive test result is a possible positive result, but means that you will need to go back to test again to confirm this. The healthcare worker will talk you through everything you need to know and help you with any worries that you may have.
You will need to give blood sample, which will then be sent to the lab for testing. At this stage, it’s very important to follow the advice of the healthcare professional.
What Is It Used For
An HIV test is used to find out if you have been infected with HIV. HIV is the virus that causes AIDS . Most people with HIV don’t have AIDS. People with AIDS have an extremely low number of immune cells and are at risk for life-threatening illnesses, including dangerous infections, a severe type of pneumonia, and certain cancers, including Kaposi sarcoma.
If HIV is found early, you can get medicines to protect your immune system. HIV medicines may prevent you from getting AIDS.
Recommended Reading: What Is The Average Life Expectancy Of Hiv Patients
What Does A Positive Test Result Mean
If you receive an HIV-positive result, the healthcare worker will talk to you about what this means and what will happen next. For most people, receiving a positive diagnosis can be a shocking and emotional experience this is completely normal. The healthcare worker is there to support you and to answer any questions that you have.
Treatment means that HIV is now a manageable illness. Your healthcare provider can link you to support and treatment services, and any other health services that you need. Any questions that you have you can ask them its their job to help answer your worries. You will most likely be asked to schedule another appointment with them in the very near future. Its very important to keep appointments and use the support offered to you. You may also be offered screening tests for other sexually transmitted infections such as chlamydia, gonorrhoea and syphilis.
Find out what questions to ask and what support is available to help you cope with the results on our Newly diagnosed page.
It has almost been eight months since I was diagnosed with HIV. I was confused, ashamed, I kept asking, ‘How this could be?’. Slowly but surely Im beginning to accept that HIV is going to be a part of me and I definitely have control over it.
– Raya