Does HIV show up on a normal blood test? Can HIV be detected through routine blood work? Understand the significance of HIV test results and the benefits of early detection and treatment.

Understanding HIV Testing: The Basics

Regular blood tests, such as a complete blood count, blood sugar, and lipid panel, do not typically include an HIV test. If you do not specifically request an HIV test, your healthcare provider will not be able to detect the presence of the virus in your blood. The main components of a routine blood test include:

• Complete blood count: Measures the levels of various blood components like red blood cells, white blood cells, and platelets.
• Blood sugar: Assesses your blood sugar levels to check for the risk of diabetes.
• Blood lipid test: Determines your cholesterol and triglyceride levels.
• Liver enzyme index: Evaluates the function of your liver.

To get tested for HIV, you will need to undergo specific HIV tests, either at your healthcare provider’s office or at a specialized testing center.

Types of HIV Tests

There are several types of HIV tests available:

1. Antigen test: This test looks for the presence of the HIV virus itself in the blood, providing information on the amount of virus present (viral load).
2. Antibody tests: These tests detect the antibodies that the body produces in response to the HIV virus. Rapid tests and home test kits are usually antibody tests, which can be done using blood or oral fluid samples.
3. Combination tests: These tests look for both HIV antigens and antibodies, providing a more comprehensive assessment of your HIV status.

The type of test used will depend on the specific circumstances and the healthcare provider’s recommendation.

Interpreting HIV Test Results

HIV test results can be interpreted as follows:

• HIV negative: This result does not necessarily mean you are completely free of HIV infection. It could indicate that you are in the “window” period, which is the time between when the virus enters your body and when your body produces enough antibodies for the test to detect. During this period, you can still transmit HIV to others, even with a negative test result.
• HIV positive: This result means that your body is carrying the HIV virus. If you receive a positive result, it is important to seek immediate medical attention for the earliest possible advice and treatment.

It is important to note that if you believe you have been exposed to HIV or are at high risk, you should get tested again, even if your initial test was negative. Repeated testing can help confirm your HIV status, especially during the critical window period.

The Benefits of Early HIV Detection and Treatment

Early detection and treatment of HIV can provide significant benefits:

1. Maintaining health and prolonging life: By starting treatment as soon as possible, you can help maintain your immune system’s strength and reduce the risk of developing serious HIV-related illnesses.
2. Living a fulfilling life: With proper treatment and management, people living with HIV can lead healthy, productive, and meaningful lives, contributing to their families and communities.
3. Preventing transmission: Effective treatment can lower the amount of virus in your body, significantly reducing the risk of passing HIV on to others.

Don’t wait until you feel sick to get tested. The sooner you know your HIV status, the sooner you can take steps to protect your health and the health of those around you.

The Importance of Regular Testing

Regular HIV testing is crucial, especially for individuals who are at high risk of exposure. Some key reasons to get tested include:

• You have engaged in unprotected sex or shared needles or other drug equipment with someone whose HIV status is unknown.
• You have been diagnosed with a sexually transmitted infection (STI), as this can increase your risk of HIV.
• You are a healthcare worker who has been exposed to HIV through needle sticks or other workplace accidents.
• You are pregnant or planning to become pregnant, as early detection can help protect your baby’s health.

Consult with your healthcare provider to determine the most appropriate testing schedule based on your individual risk factors and circumstances.

Overcoming Stigma and Seeking Support

While HIV/AIDS may still carry a social stigma, it is important to remember that there are no longer the same dire consequences as in the past. With modern treatments, people living with HIV can lead long, healthy, and fulfilling lives. If you receive a positive HIV test result, do not hesitate to seek support from healthcare professionals, support groups, and communities dedicated to helping those affected by HIV/AIDS.

Conclusion

Regular blood tests do not typically include an HIV test, and you must specifically request this test to determine your HIV status. There are various types of HIV tests available, each with its own strengths and limitations. Understanding the meaning of your test results and the benefits of early detection and treatment is crucial for maintaining your health and preventing the transmission of HIV to others. Remember, regular testing and seeking support are essential steps in managing this condition and living a healthy, productive life.

Can a normal blood test detect HIV?

This is an automatically translated article.

Regular blood tests cannot detect the presence of HIV in the body. Only when performing specialized tests such as finding HIV antigens and antibodies at the right time can HIV disease be diagnosed accurately.

1. Can HIV be detected with a routine blood test?

In general blood test does not include HIV test. If you don’t ask your doctor to test for HIV, you won’t be able to detect HIV.
The main tests in the category of general blood tests usually include only the following main tests:
Complete blood count: To quantify components of blood such as platelets, red blood cells, white blood cells.., and some of their properties such as size, amount of hemoglobin,… in the blood sample. This test helps us detect basic abnormalities in the blood, thereby providing other tests to help diagnose the exact cause of the disease. Blood sugar: Helps to measure blood sugar levels to help determine the risk of diabetes. To ensure accurate results, blood collection must be performed after 8 hours of fasting or more. Blood fat test: Helps measure cholesterol and triglyceride levels in the blood including total cholesterol, HDL (good cholesterol), LDL (bad cholesterol). Blood lipid testing also helps diagnose high cholesterol in the blood. Blood cholesterol is considered high if > 2.50 g/l. Triglycerides are considered high if > 2 g/l. Liver enzyme index: Helps determine the concentration of alanine amino transferase (ALAT or SGPT) along with aspartate amino transferase (ASAT or SGOT). These parameters help diagnose liver diseases (alcohol, viral or cancer). In addition, there are other diagnostic directions because the levels of these enzymes are also increased in some diseases such as pancreatitis or myocardial infarction.

Trong xét nghiệm máu tổng quát không bao gồm xét nghiệm HIV

2. How do I get tested for HIV?

If you suspect that you have HIV, you should see a doctor and get an HIV test or go to a preventive medicine center or large hospital to get an accurate HIV test.
Antigen test: This test looks for the HIV virus in the blood. The test can show how much virus is in the blood (also called an HIV viral load test). It is an expensive test and is not used routinely for personal screening, unless you are at high risk for HIV exposure or develop early HIV symptoms. Tests for HIV antibodies: Most HIV rapid tests or home test kits are antibody tests. This test looks for HIV antibodies in blood or body fluids. With a blood test, you will be asked to draw blood from a vein into a sample tube and send it to a lab for analysis. With a body fluid test, oral fluids are usually taken, and can be done at home. With an antibody screening test, results are usually available more quickly (in about 30 minutes). Both antigen and antibody test: This test looks for both HIV antigens and antibodies in the body. Antibodies are produced by the immune system when the body is exposed to the HIV virus, and antigens are foreign substances that enter the body and activate the natural immune system. When infected with the HIV virus, an antigen called p24 appears about 2–4 weeks after infection.

3. What do HIV test results mean?

Kết quả xét nghiệm HIV có ý nghĩa gì?

HIV negative result: This result does not mean that you are completely free of HIV infection. It means that at the time of testing your body did not carry this virus or the test did not detect the virus. There is a high chance that you are in the “window” period.
The “window” period lasts from 3 to 6 months, this is also the time for the body to produce antibodies against the virus. Therefore, if the test is done between the time the virus enters and the body produces enough antibodies, the result may be negative while the person doing the test is already infected with HIV. During the window period, you can still transmit HIV to others even though your antibody test result is negative.
If you feel you are at high risk for HIV infection and think you are in your “window” period, you should get tested again to confirm your HIV status.
HIV positive result: It means your body is carrying the HIV virus. You should not worry, go to medical facilities immediately for the earliest advice and treatment.

3. What are the benefits of early HIV detection and treatment?

Help maintain health, prolong life and live a useful life for families and the community: Get tested early if you suspect you have HIV, don’t wait until you feel tired or sick to come to the facility medical. Because at that time, the immune system has been weakened, the body no longer has enough resistance to fight pathogens, you will be very susceptible to serious infections. Therefore, it is advisable to go to a health facility as soon as you are found to be HIV-positive for advice and treatment. If your CD4 count is ≤ 350 cells/mm3 of blood, you are eligible for ART.
Helps reduce drug costs, medical costs and hospital stays: When your immune system is not severely weakened, your body is healthy, you will not get opportunistic infections. Therefore, you do not need to spend money on the treatment of severe opportunistic infections (which occur if CD4 is

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• HIV testing window period: What you need to know
• Window stage HIV can infect others
• HIV window period: How is it treated?

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HIV

Does a complete blood count test(CBC) detect HIV infection?

Finding out early about the infection allows you to begin treatment immediately, improving your health and extending your life. Early detection also helps you take precautions to prevent spreading HIV to others.

This article answers whether normal blood tests like the Complete Blood Count test can detect HIV infection. 

Routine blood tests cannot detect HIV. Specialized tests like finding HIV antigens and antibodies, when performed at the right time, can help detect HIV accurately. In simple words, the blood tests do not include an HIV test. You will not be able to detect HIV unless you ask your doctor for the test. 

The general blood tests include blood sugar tests, blood fat tests, and liver enzyme index. 

• Blood sugar test measures sugar levels in the blood to help diagnose the risk of diabetes. For accuracy in the results, blood must be collected after eight or more hours of fasting. 
• Blood lipid testing also aids in the diagnosis of elevated blood cholesterol. The blood fat test measures cholesterol and triglyceride levels, including total triglycerides, HDL (good cholesterol), and LDL (bad cholesterol). When blood cholesterol exceeds 2.50 g/l, it is considered high. Triglycerides are considered high when > 2 g/l.
• The liver enzyme index test helps determine alanine aminotransferase concentrations (ALAT or SGPT) and aspartate aminotransferase (ASAT or SGOT). These parameters aid in diagnosing liver diseases. 

Can CBC detect HIV?

A Complete Blood Count (CBC) test also falls under routine blood tests. The CBC test quantifies the components of blood, such as red blood cells, white blood cells, and platelets, and their properties, like the size and amount of hemoglobin in the given blood sample. 

The CBC test helps identify basic abnormalities in the blood, enabling subsequent tests to diagnose the exact cause of the disease. 

However, the CBC can provide the first clue that you may be infected. For example, When your white blood cell count is high, your body is likely battling an infection. Other tests can then be performed to pinpoint the cause.  

Low white blood cell counts can be due to HIV medications, conditions that affect the bone marrow, or blood infections such as lymphoma that destroy white blood cells.

Similarly, a low platelet count is common in people with advanced HIV but can also be caused by certain HIV drugs or opportunistic infections. 

How is HIV detected? 

Several types of blood tests are performed to check whether you are infected. HIV cannot be detected immediately because your body takes time to make antibodies or enough of the virus to grow inside. 

The various HIV testing types include: 

1. Standard HIV blood test 
2. Rapid blood test 
3. Antibody/antigen test
4. Rapid oral test
5. Urine test
6. Nucleic acid tests (NAT)

A positive test result indicates that you may have traces of HIV in your body. Healthcare providers never diagnose HIV based on a single test result. If you had a rapid test, get a standard lab test to confirm it.

Even if you test positive for HIV, you may not already have AIDS, the most advanced stage of the disease. Talk to your doctor immediately about starting medications called antiretroviral therapy (ART) if you have any HIV symptoms; HIV treatment can prevent you from getting AIDS. 

Bottom line 

It takes several blood tests to confirm if a person is HIV infected. Normal blood tests like CBC cannot detect HIV. However, the CBC test can indicate an early sign of an infection. 

Visit us at Grace Laboratory if you want to get your blood tested. 

HIV diagnosis and treatment

HIV diagnosis and treatment

The diagnosis of HIV infection is established by the infectious disease specialist of the AIDS Center through a comprehensive assessment of epidemiological data, the results of clinical examination and laboratory tests

The first step and the standard method of laboratory diagnosis of HIV infection is the simultaneous determination of antibodies to HIV 1, 2 and HIV p25/24 antigen. The p24 antigen can be detected on the 15th, the first antibodies – on the 30th, late – by 3-6 months.

In the laboratory of the AIDS Center, you can take an HIV test to detect antibodies and antigen. The service is completely free for citizens of the Russian Federation, confidential and, at the request of the applicant, anonymous.
The procedure is quite simple and consists of three stages:
1. pre-test counseling (conducted at the request of the patient) is a confidential dialogue with a specialist.
2. collection of material for research,
3. issue of results and post-test counseling.

In addition to the standard HIV test, in which blood is taken from a vein, there are rapid HIV tests.

They can be done with a drop of blood from a fingertip or with saliva. Such tests are more often focused on the detection of antibodies. Rapid tests are used in test-mobiles, at outreach campaigns for information, counseling and voluntary HIV testing.

It is the law that every HIV test using simple/rapid tests must be accompanied by a blood test using standard methods of testing for antibodies to HIV 1,2 and p24 antigen, or a referral of the patient for examination by standard methods.

Issuing a conclusion on the presence or absence of HIV infection only on the basis of the results of a simple (quick) test is not allowed.

Laboratory diagnosis of HIV infection can be done both at the AIDS center and at the polyclinic at the place of residence, antenatal clinic or dispensary, if you are registered there and undergo regular treatment.

An HIV test is the only way to know if you have the disease or not. HIV infection does not have external specific signs or symptoms, if during the acute period (this is about a year from the moment of infection) some ailments appear, then they all proceed as diseases known to us, for example, a cold or tonsillitis.

It is important to remember that HIV infection has an incubation period. Those. the first antibodies can be detected in about a month from the moment of infection, and the later ones – after three. All this time, a person can transmit the virus to another, for example, through unprotected sexual contact, while the HIV test may be negative (antibodies will not be detected).

This is why it is so important to get tested for HIV regularly. This will not only help stop the development of the disease, but also protect other people from infecting others.

Pre-test counseling – a conversation between a patient and a specialist – is carried out before taking an analysis (HIV test) and serves to:

– clarify and assess the risks of contracting HIV infection;

– update information about HIV, inform or correct misconceptions about the disease;

– talk about the sampling procedure

– discuss possible test results and prepare the patient for the test result.

The result of counseling is an informed voluntary consent to undergo a procedure – an HIV test. It is completed in writing and confirms the patient’s decision to undergo analysis.

When and how often should I be tested for HIV?

If there is no risk of infection in your life, then an HIV test can be taken once every 1-3 years, for example, during a medical examination.
If you had a risk, you must take an HIV test as soon as possible from a risk situation, again – after 3 months, i.e. after the end of the incubation window.

An HIV test can be either positive – antibodies to HIV and / or HIV antigen are detected, or negative – antibodies / antigen are not detected.

A negative test result for HIV antibodies is not an absolute confirmation of the absence of the disease. For several months after contracting HIV (up to 3 months), the test result may be negative. This period is called the “seronegative window” or “incubation period”, we wrote about it above – the period between infection and the appearance of antibodies to HIV.

It is important to remember: the results of the study are not communicated by phone, e-mail, by SMS informing. The result is issued at the personal request of the subject or his legal representative.

After receiving a positive result by ELISA or IHLA, the next stage of diagnosis of the disease begins. To confirm the results for HIV, confirmatory tests are used (immune, linear blot and determination of HIV RNA / DNA by molecular biological methods).

Immune or linear blot is focused on the detection of antibodies to HIV, but to specific viral glycoproteins. Molecular biological research method (PCR) allows you to identify the gene material of HIV – RNA or DNA of the virus. At the diagnostic stage, qualitative analysis is used. Unlike quantitative, it shows only the presence or absence of HIV gene material in a biological sample (blood), and not the number of viral particles.

The identification of HIV gene material is resorted to in cases where the patient needs to urgently start taking drugs, for example, if a newborn child was infected from the mother during pregnancy and / or childbirth, if the woman is pregnant and a decision needs to be made to start preventing mother-to-child transmission of HIV. For example, if there is a high risk of HIV infection, the study is carried out in the first 48 hours of a child’s life and again and at the age of 14-21 days. The most commonly used method is the detection of HIV DNA. A positive test result for HIV DNA or HIV RNA in two separate blood samples from a child at any age is laboratory confirmation of the diagnosis of HIV infection.

An HIV antibody test in children born to HIV-positive mothers will be positive until about 18 months of age. This is due to the presence of maternal antibodies in the blood of the child.

When and what tests can detect HIV gene material, p24 antigen and antibodies to HIV

The earliest detection of HIV gene material can occur on the 7-10th day from the risk situation. This study is carried out by PCR (polymerase chain reaction) and detects HIV RNA or DNA. Typically, such tests are focused on qualitative diagnostics – that is, they give an answer whether there is HIV (positive result) or not (negative result).

The 4th generation tests, which are used today in all laboratories in Russia, detect the HIV-1 p24 antigen, which appears earlier than the first antibodies. But later disappears. And antibodies to HIV-1 and antibodies to HIV-2 remain available for diagnosis. The incubation period for these tests averages 3 months.

This means that such a test can detect antibodies by the end of the first month (if a person has developed enough to determine the amount), but if the test is negative for up to 3 months, the HIV test must be repeated after the seronegative period ( incubation window.

In isolated cases, usually associated with serious disorders of the immune system, antibodies can be produced later than 3 months (for example, when taking cytostatics for cancer). In this case, the HIV test is repeated at a later date. For example, at 6 months, and with the use of post-exposure chemoprophylaxis with ARVT drugs, even at 12 months. But it is recommended to discuss such examination schemes with a doctor and conduct a study under medical supervision, taking into account all the factors and characteristics of human health.

Third-generation tests are more common today as rapid self-diagnostic tests or for diagnosis in situations where a decision must be made very quickly (for example, a woman who has not been tested for HIV goes into labor, an injury to a healthcare worker assisting a person with a sharp instrument, with unknown HIV status). Also, such tests are used on express promotions. For third-generation tests, the incubation period also averages 3 months.

SanPiN 3.3686-21 “Sanitary and epidemiological requirements for the prevention of infectious diseases” (2021): “The incubation period for HIV infection is the period from the moment of infection to the body’s response to the introduction of the virus (the appearance of clinical symptoms or the production of antibodies). It usually is no more than 3 months , however, in the presence of immunodeficiency conditions in a patient, it can increase up to 12 months.

Clinical Guidelines of the Ministry of Health of the Russian Federation “HIV infection in adults” (2020): “Stage of incubation – the period from the moment of infection until the body’s reaction appears in the form of clinical manifestations of an “acute infection” and / or the production of antibodies. The duration is usually from 4 weeks to 3 months , but in isolated cases it can increase up to 1 year.During this period, active reproduction of HIV occurs in the absence of clinical manifestations of the disease, antibodies to HIV may not be detected.The diagnosis of HIV infection at this stage is made on the basis of epidemiological data; it can be laboratory confirmed detection in the patient’s blood of HIV, its antigens (p24), nucleic acids (RNA or DNA).

If you are diagnosed with HIV infection , the specialist is obliged to inform you about this during a personal visit. That is why it is so important to come for the results of the analysis. Most often, the diagnosis is made by a specialist doctor at the AIDS Center. That is why in the medical organization where you took the test, the doctor can only tell you the result of the study and recommend that you contact the AIDS center for diagnosis and registration for dispensary observation and treatment.

During the consultation, the specialist should tell you:
– the result of the study
– explain the precautions to prevent the spread of HIV infection
– explain the guarantees of obtaining medical care and respect for rights and freedoms
– warn of criminal liability for creating a threat of infection, or for infecting another person with HIV.

Epidemiologist of the AIDS Center is obliged to conduct an investigation and clarify the source of infection. As well as the possible further spread of the virus. Therefore, a person with HIV will be asked questions regarding any situations related to the possibility of transmission of the virus:
– contact with blood in medical and non-medical organizations
– use of psychoactive substances
– sexual contacts, etc. In 30-50% of cases, people in the first year of infection develop symptoms that resemble other diseases.

After the diagnosis is established, the stage of the disease is clarified and treatment for HIV infection is prescribed.

All patients are subjected to a set of laboratory diagnostic tests to identify the following diseases when they are registered with the dispensary:

syphilis (then every 12 months)

viral hepatitis C (then every 12 months)

viral hepatitis B (then every 12 months)

toxoplasmosis (Toxoplasma gondii)

cytomegalovirus (Cytomegalovirus)

tuberculosis (then every 6 months).

Questions

Is there evidence of HIV?

Yes, there is. HIV is one of the most studied viruses. People who deny scientifically proven facts and go against public opinion are called dissidents. To learn more facts about the existence of HIV, this brochure (download) will help you.

HIV Treatment

HIV Stages of HIV Treatment Video

There are currently no drugs that can completely cure HIV. The virus remains in the human body throughout life. However, special antiretroviral drugs (ARVs) have now been developed that prevent reproduction and reduce the amount of the virus in the body, allow you to maintain or restore immune functions and prevent or cure opportunistic infections that occur against the background of immunodeficiency. Timely and correctly prescribed treatment allows you to maintain health and prolong the life of patients with HIV infection for many years.

Treatment with these drugs is called combination therapy, or antiretroviral therapy (ART). This involves taking three or four drugs at the same time. Today, treatment of HIV infection is recommended to begin immediately after the detection of the disease. This allows you to save the immune system and quickly suppress the activity of the virus, maintain quality of life and prevent the development of concomitant diseases.

The main objective of ART is the maximum suppression of HIV reproduction, which is accompanied by a decrease in the content of HIV RNA in the blood (VN) to an undetectable (PCR method) level.

However, not all people are immediately ready to start taking drugs, some people will need a year or two, or even more, to decide to start taking ARV drugs.

The principles of ART are:

voluntariness – conscious decision to start treatment and its implementation,

documented “informed consent “;

timeliness start ART as early as possible;

continuity – long-term (lifelong) adherence to the ARV regimen.

Having started such therapy, an HIV-positive person should take it regularly and without interruption for life. Otherwise, a person who skips medication or stops treatment altogether develops resistance.

Resistance is the adaptability of the virus to a given drug. This means that the virus has changed in such a way that this drug stops working on it. The set of drugs used in ART is limited, so the next time the combination of drugs is reduced. The worst thing is that changes in the virus will be transmitted further during infection. Therefore, when making a decision to start treatment, the so-called adherence or readiness for ART is very important.

Legislatively in our country, HIV treatment is provided free of charge to all citizens who need it.

Introduction to Combination Antiretroviral Therapy (download)

Myths and fears of antiretroviral therapy (download)

Antiretroviral Therapy Fatigue (download)

The patient’s consent to start treatment is confirmed by completing and signing the Informed Consent for ART

The therapy regimen is selected for each patient, taking into account the identified features – chronic diseases, mutations and resistance, tolerability of drugs and the effectiveness of their action.

Monitoring the effectiveness of treatment

In order to assess how the treatment is going, whether ARVT works and how well the immune system is, doctors prescribe a set of tests. Among them, there are two that deserve special attention.

Immune status and viral load.

There are two very important tests that all people with HIV need – immune status and viral load. It is thanks to them that it is possible to determine the degree of damage to the immune system and the effectiveness of drugs.

What is immune status?

Immune status determines the number of different cells of the immune system. For people with HIV, the number of CD4 cells or T-lymphocytes – white blood cells that are responsible for “recognizing” various pathogenic bacteria, viruses and fungi, which must be destroyed by the immune system, matters.

The CD4 cell count in an adult is usually between 600 and 1200 cells/mL.

In accordance with the WHO classification of immune disorders, the following degrees of immune disorders are distinguished:

– no immunodeficiency or insignificant: CD4 >500 µl;

– moderate immunodeficiency: CD4 350 – 499 µl;

– severe immunodeficiency: CD4 200 – 349 µl;

– severe immunodeficiency: CD4 <200 µl or <15%.

If the CD4 cell count is below 350 cells/ml, it is recommended to start antiretroviral therapy (ARVT) “for health reasons”, since with such an immune status there is a risk of AIDS-associated diseases.

A CD4 count below 350 cells/mL is indicative of severe immunodeficiency. In this case, it is necessary to take drugs not only for the treatment of HIV infection, but also for the prevention of opportunistic diseases: tuberculosis, fungal, bacterial and viral infections.

The main thing your CD4 count tells you is whether your immune system is getting worse or better.

Changes in CD4 count

Your CD4 count can go up and down as a result of infections, stress, smoking, exercise, your menstrual cycle, birth control pills, time of day, and even season, and moreover, different test kits can give different CD4 count results. .

That is why it is very important to regularly take an analysis of the immune status and look at changes in the results. It is impossible to assess the state of health of an HIV-positive person by one single analysis. If you have an infection, such as a cold or herpes, it’s best to wait until your symptoms have gone.

If you have a relatively high CD4 count (more than 500), it is sufficient to take an immune status test every 6 months. If the number of cells is less than 500 cells / ml, the examination should be carried out 1 time in 3 months.

Without a regular examination of the immune status, it is difficult to determine how the disease develops and whether a correction of the prescribed ARV therapy is necessary.

What is viral load?

Viral load measures the number of viral particles in 1 ml of blood. Viral load up to 10,000 copies/ml is not considered high.
10,000 to 50,000 copies/ml – medium
50,000 to 100,000 copies/ml and above – high.

If we compare the development of HIV infection with the train that goes to the AIDS station, then the immune status is the distance that is left, and the viral load is the speed at which the train is moving.

By changing the viral load, the effectiveness of therapy and the correct selection of drugs when taking ART are judged.

In a person who regularly takes ART drugs, after 3 months from the start of treatment, the viral load should reach an undetectable level and remain at this level throughout the entire period of treatment.

An undetectable viral load indicates that there is very little virus in the human body, which means that there is very little chance of transmitting HIV to other people, even through unprotected sexual contact. This is what the “U=U” movement is based on – undetectable burden = impossibility of HIV transmission. Any risk of sexual transmission of HIV is associated with viral load, and uncertainty reduces this risk to zero.

ART is not only good for your health, but it also protects your partners.

Treatment of concomitant diseases – hepatitis B and C, tuberculosis, herpes virus infection, toxoplasmosis, etc. – is carried out in accordance with the recommended schemes and depends on the severity of the disease and the degree of damage to the immune system.

Primary prevention (preventive treatment) of secondary (opportunistic) infections

With a deep defeat of the immune system, it is important to prevent the development of diseases, the causative agents of which have the opportunity to parasitize in the body, which is without protection. Such diseases are called opportunistic, and pathogens are called opportunists from the Latin opportunus – opportunity.
That is why opportunistic disease prevention schemes have been created for those patients in whom immunodeficiency does not allow effective protection. These regimens include drugs that are used for treatment, but at doses lower than those required to fight an existing infection.

It is very important that you take your medicines as prescribed by your doctor and according to your prescribed schedule. This can save a life, because against the background of a weakened immune system, such diseases can become fatal.

To prevent secondary infections, it is necessary to exclude their presence.

Prevention of Pneumocystis pneumonia and toxoplasmosis with CD4 count < 200 µl-1 (less than 15%) - it is recommended to take Co-trimoxazole according to the scheme until the CD4 + lymphocyte count increases on the background of ART > 200 cells/µl for 3 months.

Prevention of fungal diseases, incl. candidiasis – antifungal drugs prescribed by a doctor.

Prevention of non-tuberculous mycobacteriosis – azithromycin or clarithromycin according to the scheme.

Prevention of tuberculosis – isoniazid according to the scheme (or other drug combined in ART).

The doses of drugs and the course of treatment depend on the degree of immunodeficiency, the severity of the patient’s condition.

HIV and other diseases

Watch a video about viral hepatitis B and C https://www. aids43.ru/profilactica/about-hiv/prevention-hiv-and-hepatitis/

Information about viral hepatitis C

Reminder for HIV-positive people: what is important to remember about your health

Learning all the information about HIV treatment is not an easy task. In order to help people with HIV better navigate health issues, you need to know concise information that can help maintain their health.

1. Avoid eating raw or undercooked meat, raw fish or raw eggs. They may contain germs that are harmful to you.

2. If you have never had hepatitis A or B, talk to your doctor about getting vaccinated against them.

3. Pass medical examination prescribed by the attending physician of the AIDS Center:

Fluorography or X-ray of OGK – diagnosis of tuberculosis (1 time in 6 months)

electrocardiogram

ultrasound examination of the abdominal organs (complex)

ultrasound examination of the kidneys and adrenal glands

Examinations of doctors depending on the clinical manifestations of secondary diseases (dermatovenerologist, general practitioner, neurologist, otorhinolaryngologist, ophthalmologist, obstetrician-gynecologist, oncologist and others).

4. Going to the “dentist” regularly is very important. It is advisable to have a dental check-up twice a year. The first HIV-related diseases usually appear in the oral cavity.

5. Do not refuse visits to the doctor of the AIDS center. It is necessary to regularly take tests for viral load and immune status.

6. It is better to avoid unnecessary “activation” of the immune system, due to HIV, it already has enough work. All diseases, especially infections, even those not related to HIV, should be treated as soon as possible. When the immune system is “activated”, the virus can multiply faster.

7. HIV-positive women need to monitor the condition of the cervix. Every 6 months you need to undergo a complete gynecological examination, while it is desirable to do a cytological analysis of the cervical mucosa. This will help prevent cervical cancer.

8. If you feel constantly tired, talk to your doctor about possible anemia (low hemoglobin in the blood) or low hormone levels. Timely diagnosis and treatment of these problems can help.

9. If you are suddenly and rapidly losing weight, you will need treatment for weight loss syndrome.

10. If your immune status is above 200 cells / ml, get vaccinated according to the national vaccination schedule, this will help you avoid the severe course of infectious diseases – influenza, coronavirus infection.

11. If you have HIV, it does not mean that your child will have it. The risk of mother-to-child transmission of HIV is currently less than 2%.

12. Antiretroviral drugs may cause unwanted (side) effects in the first month of taking them. If after a month they continue to bother you, consult your doctor, perhaps the proposed treatment regimen does not suit you.

13. Immune status determines the state of the immune system, and is even more important analysis than viral load. HIV infection affects the number of CD4 cells that are destroyed by the virus. The CD4 count can be percentage (of the total number of lymphocytes), and absolute (the number of CD4 per milliliter of blood). The percentage is more stable, so it can more accurately indicate the development of HIV infection.

14. Usually, though not always, viral load “predicts” how fast HIV infection will progress. The higher the viral load, the more likely it is that the CD4 count will begin to decline rapidly in the near future. If the viral load is less than 50 copies / ml, the likelihood of disease progression is extremely small.

15. Find out what signs can be in HIV-associated cancers: Kaposi’s sarcoma and non-Hodgkin’s lymphoma. The sooner these diseases are diagnosed, the easier it will be to treat them.

The main treatment for HIV infection is a combination of three or more antiretroviral drugs. They allow you to make the viral load below the detectable level, improve the immune status and prevent HIV-associated diseases. Your doctor should choose the combination depending on your medical history and your attitude to the regimen, food restrictions (for example, take the drug on an empty stomach, or with food), and possible side effects. You need to work with your doctor to find the combination that’s right for you.

Medicines should be taken every day, on time. If you are unable to do this, it is best to talk to your doctor about stopping therapy and possibly changing the combination. Regular skipping of medications can cause the virus to become resistant to them.

Half Time Rule : If you forgot to take the drug at the appointed time and the next dose is less than half the time that must elapse between doses, then you should not drink the pill. If less, then the drug can be taken. For example, if you take the drug every 12 hours (in the morning at 7:00 and in the evening at 19.00), then in the first 6 hours after the missed tablet (i.e. until 13.00) you can take the missed tablet. If you remembered about the pass when less than 6 hours are left until the next dose, the pill should be taken only at the scheduled time, i.e. at 19.00

Do not take any medications, vitamins, or supplements, including over-the-counter ones, until you are sure they work with the medications you are taking.

It is important to take care of your eyes. If your vision has deteriorated or you have a “blurry picture”, be sure to consult a doctor.

Learn to communicate and cooperate with your doctor. Many have problems in their relationship with the doctor, others simply avoid visiting the doctor. However, as a result, you will only suffer yourself. Actively take care of your health, and this will save you from many problems in the future.

Answers to frequently asked questions about HIV infection and treatment

Do HIV antibodies disappear if I take therapy?

No, antibodies persist throughout the entire period of the disease, i.e. throughout life, even if the person has an undetectable viral load.

HIV infection – Articles for the population – Khislavichskaya district hospital

Today, perhaps, there is no person left in the world who would not know what HIV is.
HIV, or human immunodeficiency virus, is the causative agent of HIV infection and AIDS, the acquired immunodeficiency syndrome. HIV infection is an infectious disease that is caused by HIV and ends with AIDS. AIDS, or Acquired Immune Deficiency Syndrome, is the final stage of HIV infection, in which a person’s immune system is damaged to such a level that it is unable to resist any type of infection. Any, even the most insignificant infection, can cause serious illness and even death.

Human Immunodeficiency Virus
Human Immunodeficiency Virus (HIV) is a group of retroviruses called lentiviruses (also called “slow” viruses). This name is explained by their peculiarity – from the moment of infection to the time of manifestation of the first symptoms of the disease and especially before the development of AIDS, a long time passes, in some cases the process drags on for years. In 50% of carriers of HIV infection, the duration of the asymptomatic period is ten years.
When HIV enters the bloodstream, it attaches to the blood cells responsible for immunity. This is due to the fact that on the surface of such cells there are CD 4 molecules recognized by HIV. Inside these cells, HIV actively reproduces and, before an immune response occurs, the infection is distributed throughout the body. The lymph nodes, which contain many immune cells, are the first to be hit.

There is no effective response to the presence of HIV throughout the illness. This can mainly be explained by the fact that immune cells are damaged and cannot fully function. In addition, HIV is characterized by pronounced variability. The result of this is that immune cells simply do not identify the virus.

Progressing, HIV infects an increasing number of CD 4 lymphocytes (immune cells), with time their number decreases until they become critically small, which will be considered the beginning of AIDS.

How can you get infected with HIV
1. Through sexual contact. In the vast majority of cases, HIV infection is transmitted sexually. There is a lot of HIV in the semen, while the virus tends to accumulate in the semen, especially during inflammatory diseases – epididymitis, urethritis, when there are many inflammatory cells in the semen that contain HIV. For this reason, the risk of HIV transmission increases with co-infections that are transmitted through sexual contact. In addition, concomitant genital infections are often associated with the development of all kinds of formations that violate the integrity of the genital mucosa – cracks, ulcers, vesicles, and so on. HIV can also be found in vaginal secretions and cervical discharge.
During anal sex, the risk that HIV from semen enters the body through the rectal mucosa increases significantly. Moreover, with anal intercourse, the risk of injury to the rectum, that is, the occurrence of direct contact with blood, increases.
2. In injection drug users, when sharing syringes and needles.
3. During a transfusion of blood or blood components.
HIV may be present in blood products, platelets, fresh frozen plasma, coagulation factor preparations.
If infected blood was transfused to a healthy person, infection occurs in 90-100% of cases.
It is impossible to become infected with the introduction of normal immunoglobulin and special immunoglobulins, since these preparations are processed for complete inactivation of the virus.
Since the introduction of mandatory testing of blood donors for HIV, the risk of getting an infection in this way has been significantly reduced. However, if the donor is in a “blind period”, that is, when infection has already occurred, but antibodies have not formed, the recipient cannot be saved from infection.
4. From mother to child. HIV has the ability to cross the placenta, so infection of the fetus can occur during pregnancy or during childbirth. In European countries, the risk of HIV transmission from an infected mother to a child is about 13%, and in African countries – 45-48%. The magnitude of the risk depends on the level of organization of medical supervision and treatment of a woman at the stage of pregnancy, the medical indications of the mother and the stage of HIV.
Among other things, there is a real risk of transmission during breastfeeding. The presence of the virus in breast milk and colostrum of a sick woman has been proven. If the mother is HIV-infected, breastfeeding is contraindicated.
5. From patients to medical staff and vice versa. Risk levels of infection:
• 0.3% – when injured with sharp objects, on which the blood of HIV-infected people remains,
• less than 0.3% – when infected blood gets on damaged skin and mucous membranes.
It is theoretically difficult to imagine the transmission of HIV infection from a health worker to a patient. But in the 1990s, five patients were reported in the United States from a dentist who had HIV infection, and the mode of transmission was never clear. Follow-up on the patients of HIV-infected doctors (gynecologists, surgeons, dentists, obstetricians), the researchers did not reveal the facts of infection transfer.
How it is impossible to get infected with HIV
If there is a person infected with HIV among people you know, you need to know that it is impossible to get HIV:
• during sneezing and coughing
• through a handshake
• through a kiss or hug
• by eating food shared with a sick person or drinking
• in baths, swimming pools, saunas
• by “injections” in the subway. Information about the likely infection through needles placed on the seats by HIV-infected people, or through a contaminated needle prick in a crowd, is nothing more than fiction. In the environment, the virus lives for a very short time, moreover, the concentration of the virus at the tip of the needle is too low for infection.
Saliva and other bodily fluids contain very little virus, which is not enough to cause infection. The risk of infection is present if the body fluids (sweat, saliva, feces, urine, tears) contain blood.
Acute febrile phase
Approximately 3-6 weeks after infection, an acute febrile phase occurs. It does not appear in all HIV-infected people, only in 50-70%. In the rest of the patients, the incubation period is replaced by an asymptomatic phase.
The acute febrile phase has non-specific manifestations such as:
• Fever: an increase in temperature, in most cases not exceeding 37.5 degrees (the so-called subfebrile condition).
• Sore throat.
• Lymph nodes in the armpits, in the groin and on it increase, forming painful swelling.
• Pain in the head and eyes.
• Soreness in joints and muscles.
• Malaise, drowsiness, weight loss, loss of appetite.
• Vomiting, nausea, diarrhoea.
• Changes on the skin: skin rashes, the appearance of ulcers on the skin and mucous membranes.
• It is also possible to develop serous meningitis when the membranes of the brain are affected (this condition is accompanied by pain in the head, photophobia).
The duration of the acute phase is up to several weeks. After this period, the majority of HIV-infected people enter an asymptomatic phase. At the same time, in approximately 10% of patients, HIV is characterized by a fulminant course, when the condition deteriorates sharply.

Asymptomatic phase of HIV infection
The asymptomatic phase has a long course. In about 50% of HIV-infected people, the asymptomatic phase can last up to 10 years. The speed of this phase depends on how fast the virus multiplies. In the asymptomatic phase, there is a decrease in the number of CD 4 lymphocytes. When their level drops below 200 µl, we can talk about the presence of AIDS in a patient.
In the asymptomatic phase, clinical manifestations of the disease may be absent.
A number of infected patients suffer from lymphadenopathy – enlargement of all groups of lymph nodes.

AIDS – an advanced stage of HIV
This stage is characterized by the activation of the so-called opportunistic infections, that is, infections that are caused by opportunistic microorganisms, which, in turn, belong to the normal inhabitants of the human body and in the normal state cannot give rise to the disease.

First stage.
Body weight decreases by 10% compared to the original.
The skin and mucous membranes are affected by viruses, fungi, bacteria:
• Candida stomatitis: white cheesy plaque (thrush) forms on the oral mucosa.
• Hairy leukoplakia of the mouth – white plaques covered with grooves grow on the sides of the tongue.
• Due to the presence of the varicella zoster virus (the causative agent of chickenpox), shingles occurs. On large areas of the skin, as a rule, on the trunk, extremely painful rashes are formed, which are bubbles.
• Frequent bouts of herpes infection.
• Sinusitis (phronitis, sinusitis), sore throat (pharyngitis), inflammation of the middle ear (otitis) are often observed. The patient has a decrease in the number of platelets, blood cells involved in the clotting process (thrombocytopenia). This causes the appearance of hemorrhages (hemorrhagic rash) on the skin of the legs and arms, as well as bleeding gums.
Second stage.
Body weight decreases by more than 10%.
The infections already mentioned are joined by the following:
• Diarrhea for no apparent reason and/or fever lasting more than 1 month
• Toxoplasmosis
• Tuberculosis of various organs
• Pneumocystis pneumonia
• Kaposi’s sarcoma
• Intestinal helminthiasis
• Lymphomas
• Severe neurological disorders develop.
When should HIV infection be suspected?
• Fever of unknown cause lasting longer than 7 days.
• For an unknown reason (in the absence of inflammatory diseases) there is an increase in various groups of lymph nodes: axillary, cervical, inguinal, especially if the symptoms do not disappear for several weeks.
• Persistent diarrhea for several weeks.
• Signs of thrush (candidiasis) appear in the mouth of an adult.
• Herpetic eruptions of extensive or atypical localization.
• Regardless of any cause, a dramatic decrease in body weight.
Who is at increased risk of getting HIV infection
• Men of non-traditional sexual orientation.
• Injection drug users.
• Persons who practice anal sex.
• Women of easy virtue.
• People who already have a sexually transmitted disease.
• People who have more than one sexual partner, especially if they do not use condoms.
• Patients requiring hemodialysis (‘artificial kidney’).
• Those who require a transfusion of blood or blood components.
• Health workers, mostly those who come into contact with patients infected with HIV.
• Children whose mothers are infected.
Prevention of HIV
Alas, today there is no effective vaccine against HIV, despite the fact that scientists in many countries are conducting research in this direction, with which they have high hopes. At the same time, HIV prevention is currently based on general prevention measures:
1. Safe sex. Protection with a condom during sexual contact helps to avoid infection. But the use of this method of protection cannot give a 100% guarantee even if used correctly.
To make sure that there is no risk of infection, both sexual partners should undergo a special examination.
2. Avoid drug use. If it is not possible to get rid of the addiction, you need to use only one-time games, do not use syringes or needles that have already been used by someone.
3. If the mother is HIV positive, breastfeeding should be avoided.
Prevention of opportunistic infections
Infections caused by opportunistic pathogens are called opportunistic infections. Conditionally pathogenic microorganisms reside permanently in the human body and under normal conditions cannot lead to the development of diseases.
To improve the quality of life and increase its duration, prophylaxis of opportunistic infections is carried out for AIDS patients:
• Prevention of tuberculosis: in order to identify a patient who is infected with tuberculosis microbacteria in time, all patients with HIV undergo a Mantoux test every year. If there is no immune response to tuberculin (i.e., the reaction is negative), it is advised to drink anti-tuberculosis drugs for 12 months.
• Prevention of Pneumocystis Pneumonia: if an HIV-infected patient has a CD 4 lymphocyte count of less than 200/μl and an unreasonably elevated temperature (from 37.8 degrees) for two weeks, prophylaxis with biseptol is carried out.
• AIDS dementia syndrome. The gradual decline in intelligence, characterized by problems with attention and concentration, difficulty in solving problems and reading, memory loss, is called dementia.
In addition, AIDS-dementia syndrome can manifest itself as a violation in movement and behavior: it is difficult for a person to maintain a certain position, he has difficulty walking, becomes lethargic, different parts of his body begin to twitch (the so-called tremor).
Late stages of this syndrome are also characterized by fecal and urinary incontinence, in some cases a manifestation of a vegetative state.
AIDS-dementia syndrome is observed in a quarter of all HIV-infected people. The etymology of this syndrome has not been fully established. There is a version that its appearance is associated with the direct effect of the virus on the spinal cord and brain.
• Epileptic seizures. They can be caused by the following factors:
a) neoplasms
b) opportunistic infections that affect the brain
c) AIDS dementia syndrome
The most common causes are cerebral lymphoma, toxoplasma encephalitis, AIDS dementia syndrome and cryptococcal meningitis.
• Neuropathy. A common complication of HIV infection. It can appear at any stage of the disease. Varied in clinical manifestations. Early stages may be accompanied by symptoms such as progressive muscle weakness, mild sensory disturbances. After some time, the symptoms may worsen, aggravated by pain in the legs.
HIV testing
Early diagnosis is critical to successful HIV treatment and to prolonging the life of people living with HIV.

When should I be tested for HIV?

• if you have had unprotected vaginal, oral or anal sex (without a condom or if it broke in the process) with a new partner.
• if you have been sexually assaulted.
• if your sexual partner has had sex with another person.
• if your past or present sexual partner is infected with HIV.
• if needles that have already been used have been used to create tattoos and piercings, inject drugs or other kinds of substances.
• if there has been contact with the blood of a person infected with HIV.
• if your sexual partner has used used needles or has been exposed to any other risk of transmission.
• if another sexually transmitted infection has been detected.
In most cases, methods are used to diagnose HIV infection, the essence of which is to determine the content of antibodies to HIV in the blood, that is, specific proteins formed in the body of an infected person as a reaction to an infiltrated virus. Such antibodies are formed after 3-24 weeks from the moment of infection. For this reason, an HIV test can only be performed after this period of time. The final analysis is best carried out after 6 months from the time of the alleged infection.
A commonly used method for diagnosing HIV is enzyme-linked immunosorbent assay (ELISA), another name for ELISA. This method shows sensitivity to antibodies above 99.5%, therefore it seems to be the most reliable. Test results may be negative, positive, or questionable.
Treatment of HIV and AIDS
Treatment of patients diagnosed with AIDS involves the use of antiviral drugs that suppress the reproduction of the virus.
After the diagnosis is confirmed, the course of treatment of patients is determined. Treatment should be individualized and take into account the level of risk. The decision to start antiretroviral treatment is made depending on the degree of risk of progression of HIV infection and the degree of risk of immunodeficiency. If antiretroviral treatment is started before virological and immunological signs of disease progression appear, then the positive effect of it may be less obvious and long-lasting.
Therapy against viruses is prescribed for patients who are at the stage of acute infection. The basic principle of the treatment of AIDS, as well as other viral diseases, is the timely treatment of the main disease and the complications caused by it, primarily Kalosh’s sarcoma, pneumocystis pneumonia, and CNS lymphoma.
There is evidence that therapy in patients with AIDS opportunistic infections, Kaposi’s sarcoma is based on large doses of antibiotics and chemotherapy. It is best to combine them. When choosing a drug, in addition to sensitivity data, it is important to consider how the patient tolerates it, as well as the functional state of his kidneys (this is important to prevent drug accumulation in the body). The result of treatment depends, moreover, on how carefully the chosen course is adhered to, as well as on the duration of therapy.
Despite the fact that the number of drugs and treatments for patients with AIDS is quite large, the final results of treatment at the moment are very modest and do not lead to complete elimination of the disease, since clinical remissions are associated only with a slowdown in the reproduction of the virus and in some cases with visible a decrease in the morphological signs of the disease, but not with their complete disappearance. For this reason, only by preventing the progression of the virus, most likely, it is possible to give the body immunity to opportunistic infections and the formation of malignant tumors by restoring the functioning of the immune system or replacing destroyed immune cells.