HIV or the human immunodeficiency virus is a virus that targets and attacks the cells in the immune system called the CD4 cells, altering our immunity and increases the risk of other infections by reducing the body’s ability to combat other diseases.
However, a person can carry the HIV virus without experiencing any symptoms for a long time.
HIV testing shows if a person has the HIV virus in the body.
Knowing your HIV status can help keep you and others safe.
Without HIV treatment, this disease may progress to an advanced disease called AIDS.
You can be infected with HIV only through specific activities. Most commonly, people get or transmit HIV through sexual behaviors and by sharing a needle or syringe. Only certain body fluids such as blood, semen, pre-seminal fluid , rectal fluids, vaginal fluids from a person who has HIV can transmit HIV. These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream for a person to be infected.
In extremely rare cases, HIV has been transmitted by oral sex and receiving blood transfusions. This was more common in the early years of HIV, but now the risk is extremely small because of rigorous testing of the blood supply and donated organs and tissues.
Previously, HIV can be passed on by pregnant mothers to their babies, but as of 2018, Malaysian statistics of mother to child transmission has been NIL.
HIV transmission is possible at any stage of HIV infection—even if a person with HIV has no symptoms of HIV. Therefore HIV testing is necessary for early detection and HIV treatment.
HIV Ag/Ab Screening Assay is a HIV testing also known as the “combo” assay that helps detect the antibody and antigen to HIV. HIV antibody is produced 3-4 weeks after exposure, whereas the antigen (p24) can be present in detectable amounts at 2 weeks post exposure. This combination enables detection of an infected individual at the earliest possible moment by minimising the “window period” between infection and detection.
Rapid combo tests can be conducted away from specialised laboratory facilities and give results in less than 20 minutes. It is statistically as accurate as lab testing.
RNA PCR is done 10-11 days post exposure and has 99% sensitivity when performed correctly.
During this test, the lab experts look for evidence of HIV RNA in your plasma. The early detection test for HIV RNA is extremely accurate and can be used as a confirmatory test for HIV diagnosis.
Western Blot Assay is confirmatory testing for HIV I/II antibody. A positive Western Blot is generally regarded as conclusive for HIV infection. However, if the test turns out negative, it does not rule out the possibility of HIV infection as there is an interval between HIV infection and the appearance of measurable anti-HIV antibodies or so-called the “window period”. The test should then be repeated within 2-3 weeks time.
Read: STD & HIV Window Period
The ELISA test also called the EIA for enzyme immunoassay, is used to detect the HIV antibody. It checks for certain proteins that the body makes in response to HIV. An enzyme will bind with the HIV antigen or HIV antibody if the blood sample contains the HIV virus.
HIV -1 Viral Load Assay is a test done to measure the quantity of HIV-1 virus within the plasma. This test is usually done after the confirmation test turns out positive, to review the prognosis of the disease and to aid in assessing viral response to the antiviral treatment as measured by the levels.
CD4 T lymphocyte (CD4) count with HIV-1 viral load assay are the two surrogate markers of antiretroviral treatment (ART) responses and HIV disease progression that have been used for decades to manage and monitor HIV infection. Measurement of CD4 is useful before the initiation of ART. The CD4 cell count provides information on the overall immune function of a person with HIV along with other general test and examinations.
After this earliest stage of HIV infection, HIV continues to multiply but at very low levels. More severe symptoms of HIV infection, such as signs of opportunistic infections and infection-related cancers, generally don’t appear for many years and occur more frequently or are more severe in people with weakened immune systems than in people with healthy immune systems. You can click on this link to find out more about HIV symptoms.
Without treatment with HIV medicines, HIV infection usually advances to AIDS in 10 years or longer, though it may advance faster in some people.
HIV is only spread through specific bodily fluids (blood, semen, pre-seminal fluid , rectal fluids, vaginal fluids), and it is easier to prevent the infection compared to getting a cold. You do not get infected by hugging, shaking hands, sharing toilets, sharing dishes, or closed-mouth or “social” kissing with someone who is HIV-positive.
1. Practise safe sex
The most common way people get HIV is by having sex with an infected person. You can’t tell by looking at someone whether they have HIV, so you have to protect yourself and your sex partner.
You can lower your risk by using condoms correctly when you have sex.
2. Get a HIV test done during pregnancy
If you have not been tested for HIV already, then you should get it done as mother with HIV may spread the infection to their babies during pregnancy, birth and breastfeeding.
3. Don’t share needles/ equipment
If you inject drugs, don’t share the equipment. This includes everything from needles, syringes, cookers, cottons, getting tattoos/piercings and rinse water. The safest thing is to not use drugs, especially injected ones and ensuring that tattoo/piercing parlours sterilize/ change their equipment before use.
4. Pre-exposure prophylaxis, or PrEP,
Is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. PrER has shown to reduce the risk of infection up to 93% when taken consistently. The patient’s on PrEP should maintain a regular follow up with their healthcare provider to ensure proper monitoring is done.
5. Choose your partner wisely
It is important for you and you are to get tested for HIV before you start getting sexually involved. Screening eradicates the risk of contracting HIV infection and STDs.
Answer: Condoms offer protection against the spread of HIV when used correctly and consistently, however condom use will not give you perfect protection. Condoms can fail to prevent the exposure to HIV if they break, slip or leak during sex.
These types of mechanical condom failure are relatively rare, with studies estimating fail between 0.4% to 6.5% of the time.
Answer: Evidence suggests no significant risk of contracting HIV via oral sex- whether you are giving or getting oral sex.
If your screening test is positive, your doctor will get a confirmatory test and staging done for you and you will need to start on HIV medications early.
Getting early medical treatment and maintaining a healthy lifestyle will help you stay well and ensure a better quality of life. You’ll need to take your HIV medicines exactly as directed, and take precautions so others don’t get infected from you and continue a regular follow up with your doctor.
Answer: Although it had been long since the discovery of the virus, there is no HIV vaccine available at the moment. Researchers around the world are working very hard to create a vaccine for HIV.
Answer: Unfortunately, even though HIV drugs have vastly improved the quality of life for people living with HIV, they have not yet able to cure the infection. But, life expectancy and quality of life are improving with today’s medical advancements.
Availability of multiple new drugs in new classes has made it possible to suppress viral load to undetectable levels even in many of the most treatment-experienced patients. Moreover, a continuous trend to simplify the drug regime is helping many that virologically suppressed to have a better quality of life by taking a single well-tolerated pill per day.