Tue Sep 7 20:38:40 SGT 2010  
    SHIM CLINIC
168 Bedok South Avenue 3 #01-473
Singapore 460168
Tel: (+65) 6446 7446
Fax: (+65) 6449 7446
24hr Answering Tel: (+65) 6333 5550 		Opening Hours
Monday to Friday: 9 am to 3 pm, 7 pm to 11 pm
Saturday & Sunday: 7 pm to 11 pm
Public Holidays: Closed
Walk-in clinic. Appointments not required.
Bring NRIC, Visit Pass or Passport for registration.

CD4 Count Singapore Clinic
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Summary

CD4 Count Singapore Clinic: HIV symptoms/signs in men/women. Rapid HIV screening testing/check. HIV transmission/infection PEP (post-exposure prophylaxis/prevention) treatment. HIV PCR, viral load & CD4 count test clinic, Singapore - Private and confidential service. Definitions, references, and latest news.

Description

If you have been exposed to HIV in the last 72 hours, early HIV PEP (post-exposure prophylaxis/prevention) treatment can stop you from getting HIV.

Table of Contents

CD4 count
  • Used in HIV follow up management
  • Cost SG$169/=
  • Results return in 1 week.
  • CD8 count is also available separately at the same price.
HIV is the abbreviation for the human immunodeficiency virus, which causes the acquired immunodeficiency syndrome

HIV symptoms which may present in acute HIV infection:

These are nonspecific symptoms and can present with other infections; consequently, they are unreliable indicators of HIV infection.

HIV Test - The HIV window period is the time from HIV infection until a HIV Test can detect any change. Within the HIV window period, the HIV test would be negative. During this period, the HIV viral load is extremely high, thus making the person highly infectious.

  • HIV Antibody Test - For HIV Screening. 97% have a window period of 3 months. Average window period is 22 days for subtype B (ranges from 2 weeks to 6 months). Not anonymous.
    • Venous blood sampling sent to the laboratory - Results in 1-2 days.
    • Rapid HIV Test
  • Antigen testing - Average window period is 16 days. (not available)
  • HIV NAT (Nucleic Acid based Test) (HIV PCR Test) - Average window period is 12 days.
    • HIV-1 DNA PCR Test
    • HIV RNA PCR Test (HIV Viral Load)
  • Other tests
Rapid HIV Test - LIST OF RAPID HIV TEST KITS REGISTERED WITH THE HEALTH SCIENCES AUTHORITY (HSA) FOR USE IN MEDICAL CLINIC SETTINGS
  • Orasure OraQuick® Rapid HIV-1/2 Antibody Test
  • Inverness Medical Determine® HIV-1/2 Antibody Test (phased out)
OraQuick OraQuick®
  • Orasure OraQuick® Rapid HIV-1/2 Antibody Test
  • SG$60/= (no additional consultation fees)
  • Oral fluid or finger prick blood sampling.
  • Results visible in 20 minutes.
  • OraQuick® is approved for statutory testing in Singapore - it can be used for students' passes, work permits and employment passes
HIV PCR test - Two types are available:
  • HIV-1 DNA PCR Test
    • May be used to diagnose HIV infection
    • 10% false positive rate
    • Patient to arrive at clinic before 10am (Monday - Friday)
    • Cost SG$752/=
    • Results return in 2-3 weeks.
  • HIV RNA PCR Test to measure the HIV viral load
    • After HIV infection, this is used to assess disease progression during HIV follow up
    • Patient to arrive at clinic before 10am (Monday - Friday)
    • Cost SG$717/=
    • Results return in 2-3 weeks.
HIV PEP (post-exposure prophylaxis/prevention) can prevent you from getting an HIV infection, and turning HIV positive.

HIV Risk Statistics (chances of getting HIV)
HIV Risk Factors HIV Transmission Probability
Receptive anal intercourse 1/100
Receptive vaginal intercourse 1/1000
Insertive vaginal intercourse 1/2000
Insertive anal intercourse 1/2500
Receptive fellatio with ejaculation 1/2500
Sharing needles 1/150
Needle stick injury 1/300
As in a game of russian roulette, an infection could occur at the first exposure.

Individuals are eligible for HIV PEP Treatment if all the following criteria are met:

  • exposure occurred within the past 72 hours;
  • mucous membrane or non-intact skin was significantly exposed to a potentially infectious body fluid;
    • unprotected anal or vaginal intercourse
    • unprotected receptive fellatio (oral sex performed on the penis) with ejaculation
  • the potentially exposed individual is not infected or not known to be infected with HIV;
  • the source is HIV+ve or the HIV status is unknown.
Prompt antiviral therapy may reduce the risk of HIV transmission by as much as 80%.

For optimal efficacy, antiretroviral therapy should be started as soon as possible, ideally within 1 hour of exposure. So that you can remain HIV negative.

Drugs commonly used in HIV PEP:

Kaposi's sarcoma Remember, there is no HIV cure.

Sexual Health Risks in emergency situations

If you have been exposed to HIV in the last 72 hours, early HIV PEP (post-exposure prophylaxis/prevention) treatment can stop you from getting HIV.

References

Latest News

Angola: Charity Association Campaigns Against HIV/----
Tue, 07 Sep 2010 06:57:23 +0100 | AllAfrica News: Health and Medicine
An awareness campaign aimed at informing, educating and holding an interpersonal communication with residents of Samba District, in Luanda, was held Sunday here by the Christian Charitable Association ( ABC), in light of its programme of fight against decease. (Source: AllAfrica News: Health and Medicine)

BAHRAIN: No Change Seen in Ban on Entry of People with HIV
Tue, 07 Sep 2010 06:23:16 +0100 | IPS Inter Press Service - HIV/----
Bahrain may be dependent on expatriate labour, but that has not stopped it from deporting migrant workers who are found to be HIV-positive. (Source: IPS Inter Press Service - HIV/----)

Medical Brain Drain In Africa – Mbeki
Mon, 06 Sep 2010 20:57:20 +0100 | the international medical market place
Pretty shocking stats as former South African president Mbeki makes case for African universities. Add to this under funded healthcare systems in Africa, new learning democracies – compared with a vociferous thirst for additional medical talent in treating an ever aging population in the “West”, it’s not hard to see that the struggle for scarce resources is not an even playing field right now. Especially in healthcare. In 1998 South Africans numbered the largest group of foreign dentists in the United Kingdom, he said. “Only 50 out of 600 doctors trained in Zambia since independence were still practising in Zambia. More Malawi doctors were practising in the city of Manchester in the UK than in the whole of Malawi. “One estimate says that Africa lost USD ...

AIDSinfo Launches Mobile Site
Mon, 06 Sep 2010 20:23:46 +0100 | Midcontinental Region News
AIDSinfo http://www.aidsinfo.nih.gov is a U.S. Department of Health and Human Services project, managed by the National Library of Medicine, that offers the latest federally approved HIV/---- medical practice guidelines, HIV treatment and prevention clinical trials, and other research information for health care providers, researchers, people affected by HIV/----, and the general public. Along with housing the latest HIV medical practice guidelines, the Web site provides access to many other resources related to HIV treatment and research. Health information specialists are also available by phone, e-mail, and an online chat to assist the public with accessing this information. AIDSinfo now offers a mobile site http://m.aidsinfo.nih.gov/ that allows users to access its resources and inform...

Cardiovascular risk factors associated with lower baseline cognitive performance in HIV-positive persons
Mon, 06 Sep 2010 20:01:02 +0100 | Neurology
Conclusions: In this HIV-positive population with high CD4 cell counts, neurocognitive impairment was associated with prior CVD. Lower neurocognitive performance was associated with prior CVD, hypertension, and hypercholesterolemia, but not conventional HAD risk factors. The contribution of CVD and cardiovascular risk factors to the neurocognition of HIV-positive populations warrants further investigation. (Source: Neurology)

Changes in Human Immunodeficiency Virus Testing Rates Among Urban Adolescents After Introduction of Routine and Rapid Testing [Article]
Mon, 06 Sep 2010 19:50:34 +0100 | Archives of Pediatrics
Conclusions  The HIV testing rates increased significantly following publication of recommendations for routine testing and further increased following introduction of rapid testing. Combining routine and rapid testing strategies may increase uptake of HIV testing among adolescents in primary care settings. (Source: Archives of Pediatrics)

When Is a Review Article Not a Review Article? [The Pediatric Forum]
Mon, 06 Sep 2010 19:50:34 +0100 | Archives of Pediatrics
(Source: Archives of Pediatrics)

When Is a Review Article Not a Review Article?--Reply [The Pediatric Forum]
Mon, 06 Sep 2010 19:50:34 +0100 | Archives of Pediatrics
(Source: Archives of Pediatrics)

Innovation in sexually transmitted disease and HIV prevention: internet and mobile phone delivery vehicles for global diffusion
Mon, 06 Sep 2010 16:15:57 +0100 | ICMCC: The International Council on Medical and Care Compunetics
Source: Swendeman D, Rotheram-Borus MJ. Current Opinion in Psychiatry, 23(2) Content: PURPOSE OF REVIEW: Efficacious behavioral interventions and practices have not been universally accepted, adopted, or diffused by policy makers, administrators, providers, advocates, or consumers. Biomedical innovations for sexually transmitted disease (STD) and HIV prevention have been embraced but their effectiveness is hindered by behavioral factors. [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)