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Will CD4 Count Test Help In Detecting HIV?

Posted on Mon, 16 Dec 2013

Question: As you know HIV 2 cannot be exactly detected by available tests you can monitor CD4 count on every 3 months.Any significant fall in titre of CD4 count or change in CD4 to CD 8 ratio can be suggestive of infection. Hi doctor Hope you are fine . What do you mean by this as you mentioned Do you mean elisa or pcr cannot detect hiv-2 should I do every three months cd4 but cd4 is not diagnosed tool for hiv I think it's just to monitor So what the benefits of the test if they don't detect hiv-2 Please answer my questions

Answered by Dr. Sudarshan (10 hours later)

Brief Answer: CD4 count is useful with clinical symptoms Detailed Answer: Hi XXXXXXX , Thanks for writing in. To clarify your doubts you must know that- -HIV2 infection is very uncommon except in africa and some part of USA. -HIV 2 infected individuals also test positive by common tests employed to detect HIV 2 -Even tests meant for HIV1 give positive results in HIV2 infection in most cases. -Newer tests are now available to specifically detect HIV 2 infection. -Clinical symptoms of HIV and blood testing are together used to diagnose HIV. -If there is strong suspicion of HIV on clinical symptoms and HIV 1 test are negative then special test for HIV2 are undertaken. -Where the tests for HIV 2 are not available and there is strong suspicion of HIV on clinical grounds then CD4 counts and CD4 :CD8 ration are used for diagnosis of HIV. So test for HIV are beneficial and they must be done. CD4 count alone is not diagnostic . CD4 count ,CD4:CD8 ratio and clinical symptoms are used to make diagnosis of HIV. Hope this helps. I will be available for follow up. Regards DrSudarshan MD HIV and STD specialist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Sudarshan (18 hours later)

Thank you for replying doctor You said hiv-2 cannot be exactly detected by the available tests What do you mean by these tests How accurate is elisa for hiv-2 after 18 months If a person have clinical symptoms and his cd4 is low but his test is negative for both hiv 1 and 2 . How can you suggest he have hiv or another disease They said only tests can determine if the person is infected not by clinical symptoms as many diseases have same symptoms and they can drop the cd4 like cancer or lupus Many people special for hiv-2 go for years without symptoms Do I need to do pcr dna or rna for hiv-2 I'm negative for both hiv 1 and 2 by elisa for more than 18 months My health is good just I'm worried about hiv-2 only I hope you can help me in understanding these points Answer my questions please and thank you

Answered by Dr. Sudarshan (2 hours later)

Brief Answer: No further testing required Detailed Answer: Hi XXXXXXX Its good to know that your health is good.I also like Your curiosity . Persons at risk for HIV-2 infection include: 1.Sex partners of a person from a country where HIV-2 is endemic (this category includes persons originally from such countries). 2.Sex partners of a person known to be infected with HIV-2. 3.Persons who received a transfusion of blood or a nonsterile injection in a country where HIV-2 is endemic. 3.Persons who shared needles with a person from a country where HIV-2 is endemic or with a person known to be infected with HIV-2. 4.Children of women who have risk factors for HIV-2 infection or who are known to be infected with HIV-2. HIV2 can be detected by advanced tests. Investigational tests for antibodies to HIV-2, such as immunofluorescence , EIAs based on HIV-1 and HIV-2 synthetic peptides , and radioimmune precipitation , can be useful in distinguishing a true positive HIV-2 EIA screening test result. Gene amplification by polymerase chain reaction and viral culture can also be used to determine the virus type. EIA is very much reliable at 18months for HIV2. If a person have clinical symptoms and his cd4 is low but his test is negative for both hiv 1 and 2 . We can suggest he is HIV or not by typical features such as weight loss >10% body weight,fever /cough/diarrhea more than 1 month,oral candidiasis,herpes zoster,herpes simplex,tuberculosis etc. Cancer or Lupus can be detected by clinical symptoms in majority of cases and by tests for lupus and cancer. Many people special for hiv-2 go for years without symptoms. Yes thats true but it can be detected on tests. You need not do pcr dna or rna for hiv-2 as you are negative for both hiv 1 and 2 by elisa for more than 18 months. I think you should move on in life and get the fear of HIV out of you. Hope this helps. Regards. DrSudarshan

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Sudarshan (9 hours later)

Thank you doctor I really liked your explanation maybe I miss understand when you say we cannot detected . I think you mean it's always positive but hard to distinguish between both of them As many experts said elisa is > 99 to detect hiv-2 I don't have any direct to hiv-2 endemic area but when I read about known hiv-2 infected here I got doubts because I don't know if are they infected I will try my best to forget about it I want to complete my life and have family Thank you doctor

Answered by Dr. Sudarshan (15 hours later)

Brief Answer: Move on Detailed Answer: Hi, Yes it is better to forget the episode and move ahead with life. If you are satisfied with the answer please accept it and rate it at the end. I will be available for any skin,hair,nail related queries in future. Regards DrSudarshan

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Sudarshan (1 hour later)

I'm satisfy but you didn't explain last question Please answer it Thanks

Answered by Dr. Sudarshan (11 minutes later)

Brief Answer: HIV2 can be detected . Detailed Answer: Hi again XXXXXXX You do not need further testing now. As you are negative for HIV 1 and 2 ELISA. Cancer and lupus have specialized tests to detect them. 4th generation ELISA and EIA are able to detect HIV2 also. Hope this answers your query. Regards

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Above answer was peer-reviewed by : Dr. Vaishalee Punj