HIV Testing

HIV infection may be asymptomatic for many years, infected individual may not experience significant health problems. HIV test detects infection reliably. If a person is HIV positive, then it is necessary to obtain this information as soon as possible and seek medical care in one of the eight AIDS Centres in the Czech Republic immediately after learning the test result.

After each risky situation, whether sporadic or repeated one. After an accidental risk (unprotected sex, drug experiment …), it is advisable to undergo testing after three months following the risk exposure so that we can obtain a reliable result.

After recurrent risky behaviour, when the three month window period between the risky behaviour and the examination cannot be met, try to reduce primarily the risk by respecting safer practices. In that case we recommend to undergo the HIV testing ideally after six month period, however at least once a year. In this case, the HIV test result reflects a three-month- ago health condition.

In the case of high risk (e. g. unprotected sex with HIV positive person, especially unprotected anal intercourse), you can ask for testing sooner, i. e. 18 to 22 days after the risk exposure (a part of the virus called p24 antigen is also determined, in addition to antibodies). However, a negative result is not the definitive one and a further test within 3 months after the risk exposure is required to confirm that you are not infected.

Even if you are in a new relationship and partners wish to mutually share information about their medical conditions, you have to respect the window period of three months from the last risk exposure. It is advisable to test both partners.

Mandatory HIV testing (required by law) is intended in the Czech Republic for donors of blood, organs, tissues, semen, eggs, breast milk and is also carried out among all pregnant women

So-called screening test is used for routine HIV examination. Presence of antibodies to HIV as well as p24 antigen (a protein covering the HIV virus) is identified in the tested blood sample (or saliva). The examination is carried out by a number of laboratories in the Czech Republic accredited by the Czech Ministry of Health.

The negative result is reliably negative if you have complied with the three-month testing window period since the last risk exposure.

Reactive result – the screening laboratory sends a sample for final confirmation to the National Reference Laboratory that issues a definitive positive or negative result of the confirmatory HIV test, based on the confirmatory HIV test.

Testing – venous blood, capillary blood, saliva?

The HIV test can be performed in different ways:

1. Venous blood test: is a diagnostic test and the most accurate one. The medical facility that samples the blood then sends it to the laboratory to be processed. The test result is then sent to the person responsible for the blood sampling (a physician) who subsequently communicates it with the client. The disadvantage of the venous test is that the process is time consuming. The test result is usually available in a few days and a second visit in the counselling centre is required. This test detects antibodies to HIV virus (HIV1 and HIV2) and p24 antigen.

2. Testing a drop of blood from fingers (capillary blood): it is an indicative test. A blood sample is examined immediately in the counselling centre;  testing is carried out by a counsellor using a test kit for blood tests approved for this purpose. This kind of test is reliable, however if the result is reactive, then a confirmation by a venous blood test is always required. The advantage of this test is that the result is known shortly after blood sampling, which allows using this test method in contact centres, mobile ambulances, etc. This test detects antibodies to HIV (HIV1 and HIV2 types) and some types of tests also detect a presence of p24 antigen.

3. Saliva test: in this test, saliva swabs are taken from the mucous membrane of the mouth. The sample taken is usually examined immediately in the counselling centre, testing is carried out by the counsellor using a saliva test kit. Current saliva rapid tests are reliable, but a venous blood testing is always required for confirmation in case of a reactive result. The advantage is that there is no need for blood sampling and result of the test can be communicated immediately. This test examines only antibodies against HIV virus (HIV1 and HIV2 subtypes).

The test from a drop of blood or saliva can be described as a quick test with a possibility of obtaining the result already during testing. These tests are less sensitive regarding detection of early stages of the infection in comparison with standard laboratory methods, thus prolonging the immunological window at the early stage of HIV infection.

4. There is also a possibility of self-testing (tests from a drop of blood or saliva that you can perform yourself), but be careful whether a particular type of test is certified for such use. The downside is that in a particular situation when performing test at home, without professional guidance, there is no one who may advise with interpretation of the test. In the case of a reactive result, a venous blood test is required.

At every testing site, each HIV test should be accompanied by so called pre-test counselling. Information about the test result should be accompanied by so called post-test counselling. Counselling is carried out by a trained counsellor or physician.

HIV tests may be performed as a named test or anonymously.

For each tested client, it is important to find out information about the risk exposure (unprotected sexual intercourse, application of injected drugs, etc.), the time window period between the risk exposure and time of testing in order to evaluate the test results correctly.  For the purpose of monitoring the situation, it is important to know the gender, age and region of residence of tested person (also for anonymous testing). The counsellor should also communicate on how to obtain the test result.

Positive HIV antibody test results are followed by a professional post-test counselling carried out by physicians who recommend  treatment in one of the eight AIDS Centres of the Czech Republic. Adherence to  instructions given by the AIDS centres physicians plays a crucial role in ensuring that the human body is able to cope with the HIV infection as best as possible and significantly improves the quality of life of the infected patient.

More info at www.prevencehiv.cz

Test points