4 Common types of HIV tests and follow-up tests

HIV or human inmmunodeficiency virus is an infectious disease that can cause AIDS (acquired immunodeficiency syndrome). If you are among those who are at high risk of contracting or transmitting this disease, you should do an HIV test as early as possible.

Medical examination can help you quickly get the right treatment while preventing HIV transmission from spreading. What tests or checks can be done to test for HIV and AIDS?

The purpose of testing for HIV and AIDS

HIV / AIDS must be treated early because this disease can affect the condition of your body.

People with HIV who have reached the stage of AIDS generally only have a life expectancy of 3 years.

Voluntary HIV / AIDS testing is also known as the VCT test.

Having an HIV check or check can help protect others from the spread and dangers of this virus.

If the HIV test comes back positive, you can find out the stage of HIV infection.

After that, the doctor will plan a targeted HIV treatment process.

This whole series of treatments aims to make your body healthier.

In addition, treatment can also help reduce the risk of transmitting HIV to others by 96% if you regularly take HIV medication.

If the test results show that you do not have HIV or AIDS, this result can also benefit yourself and others.

A negative HIV test result can serve as a reminder for you and your partner to prevent disease by having safe sex.

Take for example, you and your partner are so obedient to use a condom and do not have multiple sex partners.

Who needs an HIV test?

Based on a regulation from the Indonesian Ministry of Health, there are several conditions that require a person to be tested for HIV and AIDS.

The prerequisites for the HIV check are as follows:

Every adult, child, and adolescent with a medical condition that is suspected of having signs of HIV infection, especially if they have a history of tuberculosis (TB) and venereal disease.
Antenatal care for pregnant women and women in labor.
Adult men who will perform circumcision as an HIV prevention measure.

Infants and children with the following conditions also need to be tested for HIV:

Children with HIV-related disease conditions such as severe tuberculosis, are regularly taking TB medication, experience malnutrition, pneumonia, and chronic diarrhea.
Newborns of mothers infected with HIV, even though they have received precautionary measures during pregnancy.
Children whose family history is unknown.
People who have the potential to have HIV infection through contaminated needles, receiving repeated transfusions, and other causes.
Children who experience sexual violence.

In addition, HIV checks should also be regularly offered to:

Commercial sex workers, injecting drug users (IDUs), homosexuals (gay), and transgender people. This group must at least repeat HIV and AIDS checks at least every 6 months.
If you have a partner ODHA (People Living with HIV and AIDS).
Pregnant women or housewives in epidemic areas (areas that have a large number of HIV and AIDS cases).
TB patients.
Everyone who visits the hospital, health center, or health center in areas where HIV cases are prevalent.
Venereal disease patients.
Hepatitis patients.
Correctional assisted residents.

Apart from what has been mentioned above, it is still important for you to undergo an annual HIV / AIDS test as well as an annual venereal disease test.

Especially if you feel that you are classified as a group at high risk of being infected with HIV / AIDS, of course it is highly recommended to undergo an examination.

What are the different types of HIV and AIDS tests?

In many cases, the diagnosis of HIV can usually be made based on clinical symptoms and several examinations from a doctor.

HIV testing generally involves a blood test because the highest amount of the virus is in the blood.

If you ask how the HIV test is done, here are the types of screening for HIV / AIDS and a description of the procedure:

1. Antibody test

Antibody testing is the most common method of testing for HIV and AIDS.

Antibodies are proteins that are produced by the immune system in response to the presence of foreign substances, such as viruses.

This HIV check aims not to look for HIV disease or virus, but to find proteins to ward off disease (antibodies).

This protein can be found in blood, urine, or saliva.

To do an HIV test, usually a doctor or nurse will take a small amount of your blood as a sample.

After that, the sample will be sent to the laboratory for further testing.

These special antibodies will appear in the blood or be produced by the body, only if you have HIV.

Generally, it takes about 3-12 weeks for the body to produce enough HIV antibodies for them to be detected in a test.

Some doctors may also recommend testing for HIV through a urine or mouth membrane (not saliva) test.

However, these fluids usually do not contain very much antibodies.

So, a urine or oral test for HIV may reveal a false negative HIV test result (false negative) or false positives (false positive).

2.Antibody-antigen (Ab-Ag) test

The HIV Ab-Ag test is a test to detect antibodies aimed against HIV-1 or HIV-2.

This HIV test also aims to find the p24 protein which is part of the virus core (antigen of the virus).

The Ab-Ag examination is important because it usually takes several weeks for antibodies to form after the initial infection even though the virus (and p24 protein) is already in the blood.

Thus, the Ab-Ag examination allows for early detection of HIV infection.

A study has shown that an HIV diagnosis can be made an average of one week earlier through Ab-Ag testing than by antibody testing alone.

The macaque method of this test uses a reaction process known as chemiluminescence.

Reaction chemilumenescene is a useful process for detecting antibody and p24 antigen protein.

In other words, if there are antibodies or antigens in the body, the result of this process will emit light on the detector.

There is only one antibody-antigen test currently approved, the Architect HIV Ag / Ab Combo test.

If the test results are positive, the doctor will recommend a further examination, namely the Western blot test.

3. Serological tests

There are three types of serological tests that are commonly recommended for testing for HIV and AIDS, namely:

Quick blood test

Rapid HIV / AIDS blood test with reagents (active chemicals) has been evaluated and recommended by the Ministry of Health.

This test can detect both HIV-1 and HIV-2 antibodies.

This HIV blood test can be run even if it only uses a small number of samples.

In addition, a rapid blood test as a test for HIV only takes about 20 minutes to find out the results.

This HIV blood test procedure can only be performed by trained medical personnel.

ELISA test

This HIV test detects antibodies for HIV-1 and HIV-2 which is done by ELISA (enzyme-linked immunisorbent assay) or also known as EIA (enzyme immunoassay).

To do an ELISA test, a blood sample will be taken from the surface of your skin and then put into a special tube.

The blood sample is then sent to a laboratory for analysis. In the laboratory, a blood sample is inserted into a petri dish containing the HIV antigen.

An antigen is a foreign substance, such as a virus, that causes the immune system to respond by producing antibodies.

If your blood contains antibodies to HIV, it binds to the antigen.

This HIV blood test will be checked by adding enzymes to the petri dish to help speed up chemical reactions.

If the contents of the petri dish change color, you may be infected with HIV.

The results of the HIV blood test by ELISA can be obtained within 1-3 days.

If the ELISA test shows a positive result, the doctor will recommend a more specific follow-up test, for example the Western bolt test to confirm a diagnosis of HIV.

Follow-up tests or supporting HIV testing are recommended because there is still a small chance that antibodies will attach to non-HIV proteins incorrectly during the first test.

That is why, a second test is needed to be sure.

Western blot test

The Western blot test is only used to follow up on the initial screening test that shows a positive result for HIV.

Usually, this test is recommended if the ELISA test is HIV positive.

Sometimes, the ELISA test can show a positive result (false positive).

This examination is also needed if you have tested positive for HIV from previous tests, but are known to have other conditions.

These other conditions include Lyme disease, lupus, or syphilis, which may affect your HIV test results.

So, in order for the results to be accurate and more certain, the tests that you have done before need to reconfirm through the Western blot test.

This HIV test is an antibody test to determine whether you are really infected with the HIV virus or not.

In this test, HIV protein is separated by size, electrical charge, and serum coated on the test strip.

If the results of the HIV test via the Western blot are positive, a series of bands (the band) which is detected indicates the presence of specific antibody binding to certain HIV viral proteins.

The Western blot test only takes 1 day for testing. However, keep in mind, this is a follow-up test or examination.

This examination does not help if it is done alone, aka without other tests.

4. PCR virological test

Virological test is a type of HIV and AIDS examination which is done by method polymerase chain reaction (PCR).

Virological testing is important for pregnant women who are HIV positive.

Newborn babies of HIV positive mothers are also required to have this examination at least when they are 6 weeks old.

Apart from babies, this test is also recommended for diagnosing children under 18 months of age if they are suspected of having HIV.

This test may also be helpful in detecting HIV infection in the first 4 weeks after exposure to the virus.

If the infant's virological test results are reported to be HIV positive at first, HIV treatment should be started immediately.

Therapy is usually started with a second blood sample drawn for a second virological test.

The recommended virological tests include:

Qualitative HIV DNA (EID)

Qualitative HIV / AIDS DNA test from complete blood or dried blood spot (DBS) is a test whose function is to detect the presence of the HIV virus, not in the antibodies that are preventing it.

This HIV check is used for diagnosis in infants.

Quantitative HIV RNA

A quantitative HIV / AIDS RNA test is performed using blood plasma.

This HIV support test is useful for checking the amount of virus in the blood (viral load HIV).

The method of checking HIV by PCR involves the help of enzymes to multiply the HIV virus in the blood.

Furthermore, the chemical reaction will show how much virus is. RNA testing results usually take a few days to a week.

Viral load HIV is declared "undetectable" if it is present in very small amounts in 1 cubical centimeter (cc) of the blood sample.

If viral load high, a sign that there is a lot of HIV virus in your body.

This can signal that your immune system is failing to fight HIV properly.

Is HIV testing accurate?

Modern HIV testing can be said to be very accurate. However, the accuracy of the test must take into account the window period.

The window period is the time when the virus enters the body until antibodies are formed. This period usually lasts from 2 weeks to 6 months.

Take for example, the 4th generation test can confirm 95% of infections by the 28th day after exposure.

Doing a confirmatory test is recommended at least after 3 months of the virus entering the body.

This period of approximately 3 months is because the virus takes time to infect the body until it finally shows a positive result on the test.

When the test shows a positive result, you can re-check it with a Western blot test.

Things that can affect HIV testing

HIV and AIDS screening is generally not affected by other conditions.

Take, for example, the infection you are currently having, the drugs you are currently taking, or your weight will not affect the test results.

Even if you consumed alcohol and drugs before the HIV test, this still does not affect the results of the HIV test.

You also do not need to fast before the HIV check because food and drinks have no effect on the results of the check.

When is the right time for the first HIV test?

If you know or remember that the first exposure to the virus occurred in less than 3 months, HIV testing is usually recommended at 3 months after exposure.

HIV.gov suggests that if someone has done activities that are at risk of HIV, you should immediately do a medical examination.

Examination sooner is better than waiting and worrying.

In conclusion, after doing things that risk causing HIV, you should not wait for symptoms or complaints to appear.

As much as possible within 3 months immediately check whether you are infected with HIV or not.

Regarding what test is best, of course the doctor will provide advice according to your condition.

The doctor can also provide about HIV prevention measures that you should take afterward.