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How Is HIV Detection Tests Done?

Posted on Wed, 30 Apr 2014

Question: Dear Dr I AM FROM INDIA At 34 days after an unprotected sex with CSW. I tested for the following HIV test available here in the Lab of eastern part of the country. Detection of HIV P24 antigen and antibody to HIV Type 1 and/or Type 2(architect abott) chemiluminescent microparticle immunoassay assy (CMIA) The test result is: Non Reactive. The test has been taken at 34 days and doctor of lab when I asked said if anything was wrong it should come by this time. However, very disappoint then knowing that INDIA has HIV type 2 virus about 2-3% cases. Which this test doesn’t test. What do you think about my HIV status?

Answered by Dr. Sankaranantham Murugan (34 minutes later)

Brief Answer: HIV 2 rarest possibility.Conclusive after 12 weeks Detailed Answer: Hi, Welcome to HCM. Thanks for posting your query. Yes, you are partially correct. As your test includes both Antigen detection and antibody detection and is one of the latest technology one. So as far as HIV 1 is (most common in India) concerned, you are sure that you are free from HIV1 infection as the test had been done after 4 weeks (34 days) of your high risk activity. Whereas the antibody part of the test (HIV1&2), at 34 days was not able to detect the antibodies, if any, as 34 days is well within window period. Only after 12 weeks it would become more conclusive. So the possibility of HIV2 infection had not been ruled out totally. But HIV 2 infection in India is less than 1% and not 2-3%. So there is nothing much to be worried and the possibility of HIV is remote in your case. Another antibody test after 12 weeks will confirm your HIV status still more conclusively. Dr S.,Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (31 minutes later)

Thanks a lot doctor. I am very tensed from this biggest mistake I have done. But this is time to make a plan. Which I want to do in advance. 1. Can I stay a bit less anxious from the information I have presented above? 2. At which CD4 count level ATR generally started in india for Type 1 and Type 2 HIV patient?

Answered by Dr. Sankaranantham Murugan (3 hours later)

Brief Answer: ART initiated when CD4 count reaches 350 cells Detailed Answer: Hi, Welcome back. 1.As HIV 1 had been ruled out in your case, you can relax. Chances of HIV 2 is remote. 2. ART as per NACO has to be started when CD4 cells goes below 350 cells/ cu.mm both in HIV 1&2. Western countries and WHO recommends ART when CD4 cell count reaches 500 cells and for all pregnant mothers, and children below 5 years of age and patients with Tuberculosis and hepatitis immaterial about their CD4 Count. Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (24 minutes later)

Thank you so much doctor. My last query: 1. As per my knowledge in western countries people with HIV can expect a near normal life expectancy with medicine and care. Is it true for Indian context? can one expect a 20-25 years of life with HIV(both type 1 and 2) with treatment and well management? 2. What could be yearly cost of treatment in our country (India)? I believe it should not be much because India is the producer of low cost medicine for HIV on which other countries of most of the world depends? Right? Thank you again for you kind prompt attention and support.

Answered by Dr. Sankaranantham Murugan (42 minutes later)

Brief Answer: Rate of ART depends on combination.Can live 30yrs Detailed Answer: Hi, Welcome once again. 1.My own patients are living more than 14 years so far with ART comfortably without any side effects or problems. I have come across who are known to have HIV for more than twenty years. I am sure if anybody follows the advice of his physician he can live more than thirty years without any problem. 2. Initially it will be around Rs.1500/ month, after 10 years, he may have to be shifted to second line. It may be around Rs.2500/. Third line my be costing around Rs.6000- 8000/ month. It is very cheaper compared to western countries. Dr S.Murugan

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar