Laboratory diagnosis of hiv

Over the past decade there have been technical advances in human immunodeficiency virus (HIV) assays and updates to testing regulations that have substantially changed the landscape of laboratory testing for HIV. In addition, there have been significant changes in the epidemiology of HIV in Australia in the context of highly effective contemporary biomedical treatment and prevention strategies. Here, we provide an update on contemporary issues for the laboratory detection and confirmation of HIV in Australia. These include (1) the impact of early treatment and biological prevention strategies on the serological and virological detection of HIV; (2) the updated national HIV laboratory case definition and its interaction with testing regulations, public health and clinical guidelines; and (3) novel strategies for the laboratory detection of HIV, including the incorporation of HIV nucleic acid amplification tests (NAATs) into testing algorithms. These developments present an opportunity to develop a nationally consistent contemporary HIV testing algorithm that would result in optimisation and standardisation of HIV testing in Australia. • About ScienceDirect • Remote access • Shopping cart • Advertise • Contact and support • Terms and conditions • Privacy policy We use cookies to help provide and enhance our service and tailor content and ads. By continuing you agree to the use of cookies. Copyright © 2023 Elsevier B.V. or its licensors or contributors. ScienceDirect® is a re...

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More than 35 years after the medical community first recognized acquired immunodeficiency syndrome (AIDS), the disease, and the human immunodeficiency virus (HIV), that causes it remain a serious global health challenge. HIV attacks the body’s immune system by destroying T cells and leaving the person susceptible to opportunistic infections or infection-related cancers, which signal that the patient has AIDS, the last stage of HIV infection. 1 The most common mode of infection is through sexual contact, followed by blood-borne and mother-to-child transmission. 2 Worldwide, 36.7 million people currently live with HIV/AIDS, but as of June 2016, only 18.2 million of those were regularly accessing antiretroviral therapy, the primary treatment for the still-incurable disease. 3 These guidelines provide an overview of the current recommendations surrounding HIV/AIDS diagnosis, treatment, and complications. DIAGNOSIS Testing Recommendations HIV testing and counseling is an essential first step in controlling the virus, but the World Health Organization (WHO) reports that only about half of people currently infected with HIV worldwide are aware of their status. 4 This proportion is even lower among people in key at-risk populations, including men who have sex with men, people who inject drugs, people in prisons, sex workers, and transgender people. People in these groups tend to test late or have insufficient links from testing to care, meaning that their immune systems are alread...

The HIV epidemic is an important public health priority. Transmissions continue to occur despite effective therapies that make HIV preventable and treatable. Approximately one-half of people with HIV are not receiving suppressive antiretroviral therapy (ART). Starting ART early, followed by continuous lifetime treatment, most effectively achieves durable virologic suppression and restoration of immune function that can improve clinical outcomes and prevent transmission to partners who are seronegative. National treatment guidelines include ART options that can be offered immediately after diagnosis, even before the results of baseline HIV drug-resistance testing are available. Initial ART selection should be guided by co-occurring conditions, including viral hepatitis, medications, and other factors such as pregnancy. Identifying and addressing psychosocial barriers to care is a key element of ensuring long-term adherence to treatment. The initial physical examination typically reveals no clinical manifestations of HIV in the absence of advanced disease. A comprehensive laboratory evaluation, including HIV viral load and CD4 lymphocyte monitoring, is necessary to guide decision-making for treatment, opportunistic infection prophylaxis, and vaccinations. The initial management of people with HIV presents a unique opportunity for family physicians to improve patients' long-term health care and reduce HIV transmissions. One-half of the estimated 1.1 million people in the Unit...

Main article: AIDS is diagnosed separately from HIV. Terminology The Performance of medical tests is often described in terms of: • • All diagnostic tests have limitations, and sometimes their use may produce erroneous or questionable results. • • Nonspecific reactions, [ citation needed] Principles Screening donor blood and cellular products Tests selected to screen donor blood and tissue must provide a high degree of confidence that HIV will be detected if present (that is, a high [ citation needed] In the US, the Food and Drug Administration requires that all donated blood be screened for several infectious diseases, including HIV-1 and HIV-2, using a combination of antibody testing ( Diagnosis of HIV infection Tests used for the diagnosis of HIV infection in a particular person require a high degree of both [ citation needed] Human rights The UNAIDS/WHO policy statement on HIV Testing states that conditions under which people undergo HIV testing must be anchored in a [ citation needed] • • Accompanied by counseling (for those who test positive); • Conducted with the Confidentiality Considerable controversy exists over the ethical obligations of health care providers to inform the sexual partners of individuals infected with HIV that they are at risk of contracting the virus. [ citation needed] In developing countries, home-based HIV testing and counseling (HBHTC) is an emerging approach for addressing confidentiality issues. HBHTC allows individuals, couples, and famil...