HIV Infection and AIDS Recent Exposure
Lab Services offer a single test to help diagnose HIV after recent exposure
or after early signs of HIV. Caution: For the majority
of newly infected individuals, early signs and symptoms of HIV will either
be absent or too subtle to be apparent. In brief, if you are at risk from
exposure to HIV then testing is indicated.
If you are sexually active with
multiple partners, have reason to believe that you have been exposed to someone
who is HIV positive, have had a recent needle stick exposure, or have had
some other recent exposure to HIV you will benefit from early testing and
treatment. Our trained professionals are standing by; please call 877- 283-7882
for further information on treatment or the early signs of HIV.
There is a new technology for the early detection of HIV after 28 days of
exposure called HIV DNA PCR. This new test looks for the DNA copy of the
HIV virus itself in your blood. It is extremely accurate and sensitive.
Proviral HIV DNA by PCR
The HIV Proviral DNA by PCR is the most sensitive test for detecting infection.
While most healthy individuals are accustomed to waiting 3 months for a conclusive
result, the HIV Proviral DNA can provide conclusive results after only 28
The DNA PCR is an antigen test, that is, a test that looks directly for
the virus. This test is conclusive well before the antibody test because
it is not dependant on an antibody response. It is looking for the actual
genetic material of HIV, called "proviral DNA." If the specimen
contains a particular HIV segment, it will be synthetically amplified (multiplied)
so that it's easily detected. If even a small amount of virus is present
in the specimen it is easily detected by this test. During acute infection
(a few days to weeks after exposure), and before the body creates an immune
response, HIV replicates to one of the highest levels throughout the entire
illness. During the first two to four weeks, plasma viremia levels can be
as high as 1 million copies per milliliter of whole blood.
The DNA PCR only needs 10 copies for detection. Although the manufacturer
recommends testing after 28 for conclusive results, a DNA PCR can clearly
be used well before that time as a strong indicator. For patients with a
high level of anxiety or strong reason to suspect infection, the DNA PCR
and other PCR based techniques can be useful even days after exposure, not
only to help rule out infection, but also to help support decisions about
post exposure prophylaxis therapy.
The DNA by PCR plays an important role in the identification of acute exposure,
and also the implementation of early treatment options. Although the clinical
significance of starting therapy during acute infection is still controversial,
some experts feel identification and treatment can significantly alter the
natural course and severity of the illness. If started early enough after
acute exposure experts hope to extend the time it takes for a person to develop
full blown AIDS and even add years to a person's life.
What are HIV and AIDS?
HIV is the abbreviation used for the human immunodeficiency
virus. HIV is the virus that causes AIDS (acquired immunodeficiency syndrome),
a life-threatening disease.
HIV attacks the body's immune system. The infection-fighting
cells of the immune system are called CD4 cells or T-helper cells. Months
to years after a person is infected with HIV, the virus destroys the CD4
cells. When the CD4 cells are destroyed, the immune system can no longer
defend the body against infections and cancers.
HIV infection becomes AIDS when you lose your ability
to fight off serious infections or tumors. Various infections called opportunistic
infections develop. They are called opportunistic because they take advantage
of the weakened immune system. These infections would not normally cause
severe or fatal health problems. However, when you have AIDS, the infections
and tumors are serious and can be fatal.
How does it occur?
HIV is not spread through the
air, in food, or by casual social contact such as shaking hands or hugging.
The virus is passed on only when the blood or sexual secretions enter another
person's body. It can also be spread to babies by the breast milk of an
infected mother. Spread of the virus can occur during such activities as:
- Unprotected sexual activity
- Sharing IV needles
- Being born to or breast-fed by an HIV-infected
- Blood transfusions (now rare in the US
because of current screening tests).
The following groups have the highest risk for
HIV infection and the development of AIDS:
- Sexually active homosexual men
- Bisexual men and their partners
- IV drug users and their sexual partners
- People who share needles (for IV drug use,
tattooing, or piercing)
- Heterosexual men and women with more than
one sexual partner
- People given transfusions of blood or blood
products in countries where the blood is not rigorously tested
- Immigrants from areas with many cases
of AIDS (such as Haiti and east central Africa)
- People who have sex with an HIV-infected
partner or with anyone in the above groups if they do not always use
a latex or polyurethane condom
- Babies born to HIV-infected mothers.
What are the symptoms or early signs of HIV?
The symptoms of HIV infection and AIDS are usually
the symptoms of the diseases that attack the body because of a weakened
- Fever that lasts from a few days to longer
than a month
- Loss of appetite or weight, especially
loss of more than 10% of body weight
- Nausea and vomiting
- Prolonged swelling of the lymph nodes
- Sore throat
- Long-lasting or multiple viral skin problems,
such as herpes sores or plantar warts
- Repeated, severe yeast infections in your
mouth or vagina despite treatment
- Chronic muscle and joint pain
- Diarrhea, especially if it lasts longer
than a month
- Enlarged spleen and liver.
The serious opportunistic diseases that most often
affect someone with AIDS include a type of cancer called Kaposi's sarcoma
and these infections: Pneumocystis carinii pneumonia (PCP), tuberculosis,
meningitis, and herpes simplex infections.
How is it diagnosed?
There is a new technology
for the early detection of HIV after 28 days of exposure called HIV DNA PCR.
This new test looks for the DNA copy of the HIV virus itself in your blood.
It is extremely accurate and sensitive.
Once you have confirmed positive HIV test results,
you must have a thorough medical exam. Your health care provider will ask
about your medical history and symptoms and will examine you.
The medical history and physical exam includes
discussing your history of sexual practices and sexually transmitted diseases.
Your health care provider will also ask about any history of drug abuse.
You will have some lab tests. Comparing the results
of the physical exam and these first lab tests with results weeks or months
from now can help your health care provider diagnose new symptoms you may
have in the future. It can also help your provider know how well your medicines
You will be tested for certain infections, such
as tuberculosis (TB), syphilis, and hepatitis B. These infections can worsen
rapidly when you have HIV. They also pose a serious risk to others.
HIV-positive women should have a Pap test according
to the schedule recommended by their health care provider (usually every
6 to 12 months).
How is it treated?
Your treatment depends on if it is known when you
became infected with HIV and whether you have symptoms. Your treatment
- Antiviral medicines, such as zidovudine
(also called ZDV or AZT), didanosine (ddI), and lamivudine (3TC), and
- Lab tests every few weeks to see how well
your immune system is working, to measure the amount of HIV in your blood,
and to screen for infections or other medical problems
- Rregular dental exams because people who
are HIV positive often have mouth problems, including gum disease
- Preventive treatment for such diseases
- Pneumocystis carinii pneumonia (PCP)
- toxoplasmosis (be sure to avoid raw meat
and cat litter boxes)
- hepatitis B
- pneumococcal infections
- Treatment for infections and tumors as
Your health care provider will probably recommend
starting treatment with antiviral drugs and antipneumonia drugs if you
are having symptoms of HIV infection. Even if you are not having symptoms,
your provider may recommend starting treatment if:
- Your CD4 cell count is below 350 cells
per cubic millimeter, or
- Your viral load is over 30,000 copies per
milliliter (mL) when using the branched DNA test, or more than 55,000
copies/mL when using the RT-PCR test.
The CD4 cell count is a good way
to know how well the immune system is working. (CD4 cells are a type of
white blood cell.) You should have this lab test every 4 to 6 months. When
the count begins to decrease, you will need to have the test more often.
The viral load test measures the amount of HIV in your
Antiviral medicines can slow the progress of the
disease, but they are not a cure. Many new drug treatments and combinations
are being prescribed or studied.
Vision problems are often early signs of HIV-opportunistic infections. Tell your health care provider promptly
about any eye symptoms, especially if you keep having blurry vision or
a loss of vision.
Getting care in an office or clinic that uses the
case management concept of care is perhaps the most important aspect of
your treatment. This approach emphasizes team care coordinated by a case
manager. The case manager helps you communicate with all who are caring
for you. Other advantages include:
- Up-to-date medical care will be available
- Treatment of the medical and social aspects
of your illness will be brought together.
- You will have help in finding resources
(medical, social, financial).
How long do the effects last?
The full effects of AIDS may not appear until 5
to 10 years after you are first infected with HIV. Although AIDS is a fatal
disease, life expectancy has increased as new treatments are developed.
How can I take care of myself?
If you are in a high-risk group but have not tested
positively for HIV, see your health care provider regularly. He or she
will examine you for early signs of HIV-associated infections and will recommend
how often your blood should be tested for HIV infection.
If you are HIV positive:
- Discuss your treatment with your health
- See your provider on a regular schedule
to keep up to date on new treatments.
- Contact a local AIDS support network. Your
provider should be able to help you find one.
Call or see your health care provider if:
- You have new or persistent symptoms.
- You notice a change in body function that
- You are having side effects from your medicine.
How can I help prevent HIV infection?
To prevent becoming infected, ask any new sexual
partner about his or her sexual history. Be careful to practice safe sex,
use latex or polyurethane condoms, and seek HIV testing. Do not share IV
If you are HIV positive, you can help prevent spreading
the virus if you:
- Practice safe sex: Do not share
sexual secretions or blood in any way. Carefully use latex or polyurethane
condoms for every oral, vaginal, or anal sexual activity.
- Ask sexual partners to be tested for HIV.
- Tell your health care providers that you
are HIV positive. (Discuss any concerns you may have about confidentiality
with your health care provider.)
- Do not share
needles for drug use, tattooing, or body piercing.
- Do not donate
blood, plasma, or semen.
- Do not plan to donate organs, such as corneas.
(If you were previously planning to donate organs, have that statement
removed from your driver's license.)
To avoid passing HIV to a baby, women should talk
to their health care providers before becoming pregnant.
Antiretroviral drugs may be used to prevent HIV
infection if you have been exposed to HIV through sexual intercourse, sexual
assault, injection drug use, or an accident. The treatment must be started
no more than 72 hours after a high-risk exposure to someone known to be
HIV-infected. The treatment lasts 28 days. This preventive treatment is
not recommended for people who are often at risk of exposure to HIV, like
those who have HIV-infected sex partners and rarely use condoms, or injection
drug users who often share equipment.
How can I keep up to date on treatments for HIV infection?
Researchers are learning more about HIV. As a result,
recommended treatments change often. Keeping up with these changes can
be difficult and frustrating. Two ways you can seek up-to-date information
and care are:
- Obtain health care from a case management
model facility and follow the recommended appointment schedule.
- Contact the AIDS Hotline with specific
questions or to find other resources.
The National AIDS Hotline: 1-800-342-AIDS (1-800-342-2437),
24 hours, 7 days a week
TDD: 1-800-243-7889 (10 a.m. to 10 p.m., EST, Monday
Spanish National AIDS hotline: 1-800-344-7432,
8 a.m. to 2 a.m., EST, 7 days a week
These hotlines are provided by the US Centers for
Disease Control and Prevention.
Related Topics: Epididymitis, Genital Herpes, Gonorrhea and Chlamydia, Hepatitis B, Hepatitis C, HIV, HIV-2, STD Testing, STD Testing for Recent Exposure, Syphillis, Urethritis, Vaginitis, Viral Hepatitis.
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