A human immunodeficiency virus (HIV) test detects antibodies to HIV or the genetic material (DNA or RNA) of HIV in the blood or another type of sample. This determines whether an HIV infection is present (HIV-positive).
But what don’t you know about this test?
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HIV infects white blood cells called CD4+ cells, which are part of the body’s immune system that help fight infections. HIV can progress to acquired immunodeficiency syndrome (AIDS).
How Long Does It Take?
After the original infection, it takes between 2 weeks and 6 months for antibodies to HIV to appear in the blood. The period between becoming infected with HIV and the point at which antibodies to HIV can be detected in the blood is called the seroconversion or “window” period. During this period, an HIV-infected person can still spread the disease, even though a test will not detect any antibodies in his or her blood.
Several tests can find antibodies or genetic material (RNA) to the HIV virus. These tests include:
Enzyme-linked immunosorbent assay (ELISA). This test is usually the first one used to detect infection with HIV. If antibodies to HIV are present (positive), the test is usually repeated to confirm the diagnosis. If ELISA is negative, other tests are not usually needed. This test has a low chance of having a false result after the first few weeks that a person is infected.
Western blot. This test is more difficult than the ELISA to perform, but it is done to confirm the results of two positive ELISA tests.
Polymerase chain reaction (PCR). This test finds either the RNA of the HIV virus or the HIV DNA in white blood cells infected with the virus. PCR testing is not done as frequently as antibody testing, because it requires technical skill and expensive equipment. This test may be done in the days or weeks after exposure to the virus. Genetic material may be found even if other tests are negative for the virus. The PCR test is very useful to find a very recent infection, determine if an HIV infection is present when antibody test results were uncertain, and screen blood or organs for HIV before donation.
Testing is often done at 6 weeks, 3 months, and 6 months after exposure to find out if a person is infected with HIV. The two types of HIV are: HIV-1, which causes almost all of the cases of AIDS worldwide; and HIV-2, which is found mostly in West Africa.
Why It Is Done
A test for the human immunodeficiency virus (HIV) is done to:
Detect an HIV infection. Testing is often done for people with risk factors for HIV infection and people who have symptoms of an HIV infection.
Screen blood, blood products, and organ donors to prevent the spread of HIV. Screen pregnant women for HIV infection. The United States Preventive Services Task Force recommends all pregnant women be screened. Pregnant women who are infected with HIV and receive treatment are less likely to pass the infection on to their babies than are women who do not receive treatment.
Find out if a baby born to an HIV-positive woman also is infected with HIV. PCR is often done in this case because the baby may get antibodies against HIV from the mother and yet not be infected.
The Centers for Disease Control and Prevention (CDC) recommend HIV screening as part of routine blood testing. You and your doctor can decide if testing is right for you.
This test is not done to determine if a person has AIDS. A diagnosis of AIDS means a person is HIV-positive and other problems are present.
How To Prepare
You do not need to do anything before you have this test. Also, a test for HIV infection can’t be done without your consent. Most doctors offer counseling before and after the test to discuss:
- How the test is done, what the results mean, and any other tests that may be done.
- How the diagnosis of an HIV infection may affect your social, emotional, professional, and financial outlooks.
- The benefits of early diagnosis and treatment.
- Before the test, it is important to tell your doctor how and where to contact you when your test results are ready. If your doctor has not contacted you within 1 to 2 weeks of your test, call and ask for your results.
How It Is Done
The health professional drawing blood will:
- Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
- Clean the needle site with alcohol.
- Put the needle into the vein. More than one needle stick may be needed.
- Attach a tube to the needle to fill it with blood.
- Remove the band from your arm when enough blood is collected.
- Apply a gauze pad or cotton ball over the needle site as the needle is removed.
- Apply pressure to the site and then a bandage.
How It Feels