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HIV AIDS Control Tips: Different Types Of HIV Tests, And Their Importance In Managing Symptoms
VERIFIED HIV AIDS Control Tips: Different Types of HIV Tests, and Their Importance In Managing Symptoms Are You Suffering from HIV AIDS? Take a look at these important HIV tests that can help you manage the symptoms. HIV tests are broadly categorized into screening, confirmation, or treatment monitoring. All tests for HIV screening and confirmation of diagnosis should include pretest counseling before performing the tests and post-test counseling before disclosing the results. It may be necessary to refer the patient to appropriate services such as HIV specialists and Integrated Counseling and Testing Centers (ICTC) following NACO guidelines.
We spoke to Dr. Niranjan Patil, AVP, and Scientific Business Head - Infectious Diseases, Microbiology & Molecular Biology- Head & Biosafety officer, Metropolis Healthcare Limited, to understand more about HIV screening and different ways in which this condition can be managed.
Tests for HIV screeningIn India, HIV screening is conducted following the NACO guidelines for HIV testing. Serological tests, such as HIV1 and 2 antibody tests, can be performed. For individuals aged over 18 years who are clinically asymptomatic, the sample should react to HIV antibodies with three different kits (Strategy III) as per NACO guidelines. Antibody-based tests can take various forms, such as ELISA, CMIA, CLIA, ELFA, lateral flow immunochromatography-based rapid tests, immunofiltration, etc.
Currently, 4th generation assays based on antigen-antibody interactions can be performed, reducing the window period for detection. The window period for antibody-based tests is the time gap between the entry of the HIV virus into the human body and the appearance of detectable antibodies in human serum or plasma samples. This period may vary from 6 weeks to 6 months from person to person, depending on various factors. During the window period, HIV antibody tests may yield false-negative or non-reactive results. HIV antigen-based or HIV PCR-based tests may be recommended for HIV diagnosis during this window period for antibody-based tests.
For newborn infants and children under 18 months of age, maternally acquired antibodies may interfere with antibody-based serological screening tests for HIV. It is recommended to perform nucleic acid-based qualitative tests such as HIV1 proviral DNA PCR, HIV2 RNA PCR, or HIV p24 antigen tests. NACO recommends the use of a dried blood sample to perform DNA PCR tests between 6 weeks to 18 months of age for the diagnosis of HIV in infants.
HIV Tests For ConfirmationAn HIV 1 and 2 western blot test may be performed, which looks for various proteins of HIV1 and 2. However, it has a longer window period of detection compared to the screening tests and is recommended to be performed for confirmation of the screening results obtained from the antibody-based tests.
Alternatively, HIV testing can be conducted using nucleic acid-based tests such as HIV1 RNA PCR and HIV2 RNA PCR.
HIV tests for treatment monitoring
For known HIV-positive patients who are consuming HIV anti-retroviral agents, viral load tests such as HIV-1 and HIV-2 quantitative viral load tests, which look for HIV RNA viral copies, are used to monitor the response to treatment. These viral load-based tests may be performed at 6-month intervals to assess prognosis. Additionally, tests such as CD4 counts may be used as an additional parameter to monitor the response to anti-viral treatment.
Apart from these, there are tests meant for the detection of resistance to anti-retroviral agents referred to as HIV drug resistance tests, which may be genotypic or phenotypic. Generally, HIV genotypic tests involve DNA/RNA sequencing, which includes performing PCR followed by sequencing of the nucleic acid. This is followed by comparing the sequence obtained with a standard database using sophisticated software algorithms. These HIV drug resistance tests help the HIV specialist doctor choose and alter anti-HIV medications during the course of treatment for an individual patient.
Metropolis has been a pioneer in HIV testing in the private diagnostics sector for more than three and a half decades now and has been an active partner with NACO and the Government of India for HIV viral load testing.
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Immigration Federal Privacy Policy May Have Impacted HIV Status Among Black American Women
by Atiya Jordan December 19, 2023
Before January 2010, foreign nationals with an HIV positive test were banned to enter and stay in the United States.
A recent interview revealed that Department of Homeland Security (DHS) officers upheld a dangerous federal privacy policy that may have impacted the HIV status of many African American women and children because of marriages to African men.
The Center for Immigration Studies interviewed Richard Lee, a retired DHS adjudicator from Charleston, South Carolina. He is no stranger to sharing his journey into the hidden corners of the American immigration system.
As the author of After the Border: 42 Eye-Opening, Shocking, Crazy, Happy & Fun Stories, Lee unravels "often obscured" narratives, especially those that "employ fraudulent marriages as a means to secure entry into the United States." Among other stories, Lee encountered African men during the adjudication process who did not disclose to their African-American wives that they were HIV positive.
"DHS had ruled that privacy (for the HIV-carrying male alien) was regarded as more important than the health of: 1) the woman involved, usually a Black U.S. Citizen; 2) any babies born to that couple; and 3) by extension, the public health of Americans generally," the report found based on Lee's testimony.
According to Lee, from 2003 to 2008, immigrants seeking entry in the U.S. Were required to submit proof of a negative HIV test. A positive result, on the other hand, "could bar the applicant" from entering and residing in the country. But immigrants were able to "waive that HIV status" through the United States Immigration and Naturalization Service, which was dissolved in 2003. Most of the petitions were approved.
Lee said that he and his fellow officers were forbidden to tell the wife of the husband's health condition. This was especially enforced in Atlanta, where he witnessed several such cases a week. In essence, the system essentially found "immigration-related spouse-deception" permissible, the Center for Immigration Studies noted.
Despite these orders, some officers tried to alert the family indirectly without completely dishonoring the federal privacy policy. According to Lee—
"I had a West African male come into the immigration office. As I reviewed his case and started the adjudication process, I looked at his medical records … every applicant who comes into the office must submit an I-693 medical exam for adjustment of status. On that medical exam, they must list any medical conditions they have…"
"Some of the standard questions that we asked were discussed with the [other] immigration officers. We frequently asked, 'Hey, are you guys planning on having children?' And inevitably, the African American woman almost always said, 'Yes, we're planning on having kids.' The West African man would always say, 'No, I'm not planning on having kids because of HIV.' I separated the husband and wife during the interview. … And I would always ask the West African man … 'Have you told your spouse that you have HIV?' All the time, the men would respond, 'No, I have not told her.'"
During that time, most experts assumed that more than 90% of HIV in African adults resulted from heterosexual transmission. Meanwhile, as of December 31, 2000, 774,467 persons had been reported with AIDS in the United States, the CDC reported.
Of those individuals, 448,060 of these had died, and 3,542 persons had "unknown vital status." Of the number of persons living with AIDS (322,865), 79% were men, 61% were black or Hispanic, and 41% were infected through male-to-male sex.
In January 2010, the ban on HIV-positive foreign nationals ended and stopped being an automatic ground for inadmissibility.
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