HIV testing and important things in it

An HIV test is an examination procedure performed to detect HIV infection in a patient's body. With the detection of HIV, besides being beneficial to themselves, the individual can also be more careful not to spread HIV to other people. There are two methods in the HIV test, namely an HIV test that checks for antibodies produced by the immune system as a reaction to HIV infection, and an HIV test that checks for the presence of the virus in the body. HIV testing has several important functions, among others, to prevent the spread of HIV, detect HIV infection early, and detect blood, blood products, or organs from donors before being given to other patients. With early detection, treatment becomes faster, and the risk of transmission of the virus can be reduced.

Indications for HIV testing

HIV testing should be carried out by every individual, especially those aged between 13-64 years, as part of routine health checks. However, doctors will recommend HIV testing in some people with the following conditions:

• Having symptoms that are suspected of HIV or being diagnosed with certain health problems, including sexually transmitted diseases, hepatitis B or C, tuberculosis, and lymphoma.
• Change partners frequently and have unprotected sex.
• Having same-sex sex.
• Using drugs by injection or infusion and sharing syringes.
• Pregnant or nursing women.
• A new baby is born by a woman with HIV.
• Receive blood transfusions from donors who come from countries with high numbers of HIV sufferers

Doctors recommend that patients at high risk of HIV undergo routine HIV testing once a year. For patients suspected of being exposed to the HIV virus, the test should be carried out at 6 weeks, 3 months, and 6 months from the first exposure to the virus.

HIV Test Warning

There are several things that can affect HIV test results, including:

• Having health problems, such as autoimmune diseases, leukemia, or syphilis.
• Take corticosteroid drugs.
• The window period (window period), the period in which antibodies to HIV have not yet formed, so the test results are still negative.
• Excessive consumption of alcoholic beverages.

The above circumstances can make HIV positive test results even though the patient is not infected with HIV (false positive), or vice versa negative test results even though the patient is infected with HIV (false negative).

Before HIV testing

Generally, patients do not need special preparation before undergoing an HIV test. However, the doctor will offer counseling before and after the test to discuss various matters, including:

• How the HIV test is carried out, the interpretation of test results, and other possible tests.
• How a diagnosis of HIV infection can affect a patient's social, emotional, professional and financial outlook.
• Various benefits of diagnosis and treatment from an early age.

It is important to tell the doctor how and where the doctor can contact you when the test results come out.

Types of HIV Tests

HIV testing consists of various types and there is no perfect HIV test. Therefore, sometimes it is necessary to do several tests or repetition of the test to confirm the diagnosis. There are three main types of HIV testing, including:

• An antibody test

which is a type of examination to detect HIV antibodies in the blood. HIV antibodies are proteins produced by the body in response to HIV infection. The antibody test consists of several types, including:
• ELISA (enzyme-linked immunosorbent assay). ELISA is an HIV test that is generally used as a first step to detect HIV antibodies. Blood samples that have been taken will be taken to the laboratory and put into containers that have been given HIV antigens. Furthermore, the enzyme will be put into the container to accelerate the chemical reaction between blood and antigens. If the blood contains HIV antibodies, the blood will bind to the antigen in the container.
• IFA (immunofluorescene antibody assay). Tests are carried out using fluorescent dyes to identify the presence of HIV antibodies. Observations were made with the help of a high-resolution microscope. This test is usually used to confirm the results of an ELISA test.
Western Blot. The test is carried out using a method of separating the antibody protein extracted from blood cells. Previously, this test was also used to confirm ELISA test results, but now Western Blot is rarely used as an HIV test.

• PCR (polymerase chain reaction) test.

Test used to detect HIV RNA or DNA in the blood. PCR testing is done by multiplying DNA through enzyme reactions. PCR testing can be done to confirm the presence of the HIV virus when antibody test results are still in doubt.

• Antibody-antigen combination test (Ab-Ag test).

Tests carried out to detect HIV antigens known as p24 and HIV-1 or HIV-2 antibodies. By identifying the p24 antigen, the presence of the HIV virus can be detected early before HIV antibodies are produced in the body. The body generally takes 2-6 weeks to produce antigens and antibodies in response to infection.

HIV Test Procedure

HIV testing is generally done through a blood sampling procedure. The steps to draw blood are as follows:

• The patient's upper arm will be tied with an elastic cord to block the flow of blood, so that the blood vessels under the bond enlarge and will more easily pierce the needle into the vein.
• The area of ​​the skin to be pricked by the needle is cleaned with alcohol.
• The doctor will stick the tip of the needle into the vein and put a tube in the other end, then the blood will be filled into the tube.
• After the amount of blood drawn is enough, the doctor will remove the elastic strap from the patient's arm.
• Alcoholic gauze or cotton gauze is used to compress the injection area when the needle is removed.
• The doctor will cover the injection site with a bandage or wound bandage.

HIV Test Results and After HIV Tests

Blood samples that have been taken will be analyzed in a laboratory to detect antibody responses to HIV or genetic material (DNA or RNA) of HIV in the blood. ELISA test results will generally come out in 2-4 days, Western Blot or IFA test results take 1-2 weeks, while the PCR test results take 2-6 weeks. There are several types of HIV test results, namely:

• Normal or negative.

Test results are said to be normal or negative if:
• No HIV antibodies were found in the patient's blood.
• The PCR test did not detect the presence of HIV RNA or DNA.

• Abnormal or positive.

Test results are said to be abnormal or positive if:
• HIV antibodies are found in the patient's blood.
• PCR tests detect the presence of HIV genetic material (RNA or DNA).

• Cannot be determined (indeterminate result).

Test results do not indicate clearly whether the patient is infected with HIV or not. This condition may occur when HIV antibodies have not yet developed or when other types of antibodies interfere with test results. If this happens, a PCR test can be done to see the presence of the virus. Patients who continue to have uncertain test results for 6 months or more are called stable indeterminate and are considered not infected with HIV.

If the results of an HIV test are negative, it does not mean the patient is not infected with HIV. Patients may still be in the virus incubation period or in the window period, which is the time span from the initial transmission to the appearance of HIV antibodies. The doctor will advise the patient to undergo a retest 3 months after the first test. This is done to ensure test results and as a preventative measure for the spread of the virus. If the results of a repeat HIV test remain negative, the doctor will declare you are not infected with the HIV virus, but still recommend regular HIV examinations for early detection of HIV infection If the patient is tested positive for HIV, then the patient and doctor can discuss to plan the steps and types of treatment therapy that will be undertaken by the patient. There are some initial steps that will be recommended by doctors after being diagnosed with HIV, including:

• Discussing with fellow HIV sufferers will greatly help the patient through the initial period after diagnosis.
• Taking antiretroviral drugs (ART) to inhibit the development of HIV and help protect the patient's immune system, and the risk of transmission can also be suppressed.
• Undergoing further examination to prevent the possibility of sexually transmitted diseases (STD).
• Use a condom when having sexual relations with a partner.
• Ask your partner to undergo an HIV test.

Risk of HIV testing

Blood sampling procedures for HIV testing are generally safe and rarely cause side effects. If there are, patients may only experience mild side effects, such as:

• Dizziness or headache.
• A small bruise (hematoma) appears at the injection site.
• The arm aches and feels weak.
• Infection at the injection site.

Psychological side effects may occur, especially if the patient is tested positive for HIV. Patients will experience depression, irritability, and anxiety. Bleeding can occur in patients with blood clotting disorders. Consumption of blood-thinning drugs, such as aspirin and warfarin, before the blood-taking procedure will increase the risk of bleeding. Contact your doctor immediately if you experience this condition.