December 1 has been observed as World AIDS Day since 1988. The day provides an opportunity for individuals and organizations across the globe to work actively and collaborate to raise awareness about HIV and move closer to the goal of an AIDS-free generation. The theme of World AIDS Day through 2015 is “Getting to Zero”. In the U.S., the federal government’s theme for the day is “The Time to Act Is Now”.
According to the CDC, an estimated 36.9 million people are living with HIV/AIDS worldwide. The organization recommends that all adults and adolescents from ages 13 to 64 should be tested at least once for HIV. Viral suppression can be promoted with early HIV diagnosis, timely treatment, and HIV medical care, improving the health of persons living with HIV, increasing survival, and preventing transmission to others.
Blood tests can detect HIV infection sooner after exposure than oral fluid tests because the level of antibody in blood is higher than it is in oral fluid. HIV diagnostic tests include antibody tests, antigen/antibody tests, and nucleic acid (RNA) tests. Serum or plasma samples are first screened using a test with high sensitivity, usually the enzyme-linked immunosorbent assay (ELISA) or rapid test. ELISA test kits are relatively simple to use and suitable for testing large numbers of samples. If the initial test result is positive, follow-up lab tests will be recommended, which include the following:
- CD4/T-cell count – to check how well the immune system is functioning
- Viral Load (VL) – to measure the amount of HIV in blood
- Drug resistance testing – to ensure the particular strain of HIV is not already resistant to certain medications
- Complete Blood Count (CBC) – to measure the concentration of RBCs, WBCs, and platelets in the blood sample
- Blood chemistry tests – to examine the levels of different elements and waste products in the blood and help determine how well different organs are functioning
- Urine tests – to check kidney function and infections
- STD screening – to check whether the patient is infected with other sexually transmitted diseasessuch as gonorrhea, syphilis, herpes, and chlamydia
- Hepatitis A, B, and C blood tests – to check for current or past infection with Hepatitis A, B, or C
More than 1.2 million persons aged 13 years and older in the United States are infected with HIV. Clinical laboratories should focus on supporting the cause of World Aids Day with quality diagnostic and screening tests to confirm antibody and antigen/RNA.