Sat Feb 4 23:20:13 SGT 2012  
    SHIM CLINIC
STD CLINIC SINGAPORE™
168 Bedok South Avenue 3 #01-473
Singapore 460168
Tel: (+65) 6100 7446 (SHIM)
Fax: (+65) 6449 7446
24hr Answering Tel: (+65) 6333 5550 		Opening Hours
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HIV Screening | Shim Clinic, STD CLINIC SINGAPORE™
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Summary

HIV Screening | Shim Clinic, STD CLINIC SINGAPORE™: HIV screening test/check 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 infected with HIV.

Table of Contents

Note: With the exception of the Western Blot test, the antibody or antigen test is usually a HIV ELISA test

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.

OraQuick® rapid HIV test cost/price is S$60/=. No additional consultation fees are charged if the clinic attendance is only for this test.

Window
period 		Test Notes Cost /
Price
2 weeks HIV DNA test
  • A HIV NAT (nucleic acid test) for HIV-1 proviral DNA
  • A HIV PCR (polymerase chain reaction) test. Method: Proviral DNA Polymerase Chain Reaction (Roche Amplicor HIV-1 DNA Test, V1.5) This test uses primers SK145 and SKCC1B to define a sequence of 155 nucleotides within a highly conserved region of the HIV-1 gag gene.
  • HIV window period can be as short as 10-12 days
  • Usually used for the early diagnosis of HIV infection in neonates born to HIV+ mothers. As maternal antibodies circulate in the child for several months, the HIV antibody test would be positive.
  • Patient to arrive at the clinic before 10am (Monday to Friday only)
SG$752/=
1 month HIV p24 antigen test
  • A HIV antigen test that tests for the HIV p24 antigen, which appears in early infection, before the appearance of HIV antibodies. But later declines when the HIV antibodies begin to appear.
  • Usually packaged with the HIV-1/2 IgM/G antibody test, to becomes a 4th generation HIV ELISA test
SG$48/=
3 months OraQuick® SG$60/=
3 months HIV blood test most commonly sent to the lab. SG$12/=
HIV
confirmation 		HIV western blot test SG$275/=
HIV
follow-up 		HIV RNA test
  • A HIV NAT (nucleic acid test) for HIV-1 RNA of the free virus, giving the HIV viral load
  • A HIV PCR (polymerase chain reaction) test. Test Method: Abbott Realtime HIV-1
  • Usually used to monitor the progress of HIV+ patients on treatment.
  • Patient to arrive at the clinic before 10am (Monday to Friday only)
SG$717/=

References

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.

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 risk

HIV Risk Statistics (chances of getting HIV)
HIV Risk Factors HIV Transmission Probability
Needle stick injury3 1/300
Receptive anal intercourse4 1/100
Receptive vaginal intercourse5 1/1000
Insertive vaginal intercourse4 1/2000
Insertive anal intercourse4 1/2500
Receptive fellatio with ejaculation4 1/2500
Sharing needles6 1/150

As in a game of russian roulette, an infection could occur at the first exposure.

References

  1. Cardo DM, Culver DH, Ciesielski CA, et al. A Case-Control Study of HIV Seroconversion in Health Care Workers after Percutaneous Exposure. N Engl J Med. 1997;337:1485-1490.
  2. Katz MH, Gerberding JL. Management of occupational and nonoccupational postexposure HIV prophylaxis. Current Inf Dis Reports. 2002;4:543-549.
  3. Gerberding JL. Prophylaxis for Occupational Exposure to HIV. Ann Intern Med. 1996;6:497-501
  4. Vitinghoff E, Douglas J, Judon F, et al. Per-Contact Risk of Human Immunodificiency Virus Transmision between Male Sexual Partners. Am J Epidemiol. 1999;150:306-311.
  5. Peterman TA, Stoneburner RL, Allen JR, et al. Risk of Human Immunodeficiency Virus Transmission From Heterosexual Adults With Transfusion-Associated Infections. JAMA. 1988;259:55-58. [Erratum. JAMA. 1989;262:502]
  6. Kaplan EH, Heimer R. A Model-Based Estimate of HIV Infectivity via Needle Sharing. J Acquir Immune Defic Syndr. 1992;5:1116-1118.
HIV PEP (post-exposure prophylaxis/prevention) treatment can prevent you from getting an HIV infection, and turning HIV positive.

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;
  • 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.

The medications and dosages are the same as those used for lifelong treatment of HIV patients. However, for HIV PEP treatment, it is taken for only a month.

Drugs commonly used in HIV PEP:

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

TORCHES

TORCHES is a medical acronym for a set of perinatal infections (i.e. infections that are passed from a pregnant woman to her fetus), that can lead to severe fetal anomalies or even fetal loss.
Other agents are:

Sexual risk (of STD/HIV/pregnancy), and what you can do before and after exposure.

TimelineEvent / Available resources
Before exposure
STD / HIV exposure Unsafe sex / unprotected sex:
0-72 hours
2 weeks
1 month
  • HIV p24 antigen test
3 months
  • Rapid HIV test will be positive in 97% of infected individuals
    • HIV test cost is SG$60/= (HIV test only)
    • Oral fluid or finger prick blood sampling.
    • Results in 20 minutes.
  • STD testing
6 months
Anytime
  • Full/total/complete STD testing:
    • Men who practice insertive sex SG$497/=
    • Women who practice vaginal sex SG$737/= (includes Digene® HPV DNA & ThinPrep® test)
    • Either sex practicing anal sex SG$697/= (includes Digene® HPV DNA test)
    • Other variations - discuss with the doctor.
    • Hold your urine in your bladder for at least 4 hours.
  • STD treatment when STD symptoms appear.
  • Genital warts treatment/removal/cure

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 infected with HIV.

References

Latest News

Tanzania: Search On for New Supplier of HIV Test Kits
Mon, 30 Jan 2012 13:07:51 +0100 | AllAfrica News: Health and Medicine
Daily News (Dar es Salaam)-THE process to get a new supplier of HIV/---- Rapid Test Kits in the country is undergoing requisite procedures, to make sure that only a reputable firm lands the tender, it has been said. (Source: AllAfrica News: Health and Medicine)

Rwanda: New HIV Test Kit Under Evaluation
Mon, 30 Jan 2012 07:59:04 +0100 | AllAfrica News: HIV----- and STDs
[New Times] A new HIV testing kit is under evaluation to replace the SD Bioline, an HIV testing device, which was recently removed by the World Health Organization (WHO) from its list of approved rapid test kits after it failed quality assurance tests. (Source: AllAfrica News: HIV----- and STDs)

Kenya: Shortage of HIV Test Kits Raises Concerns
Fri, 27 Jan 2012 14:02:28 +0100 | AllAfrica News: Health and Medicine
PlusNews (Johannesburg)-Voluntary counselling and testing centres around Kenya are turning people away due to a shortage of HIV testing kits after the recall in December of more than one million faulty HIV tests. (Source: AllAfrica News: Health and Medicine)

Study Compares HIV Saliva Self-Test To Blood Test
Thu, 26 Jan 2012 08:00:00 +0100 | Health News from Medical News Today
A saliva test used to diagnose the human immunodeficiency virus (HIV), is comparable in accuracy to the traditional blood test, according to a new study led by the Research Institute of the McGill University Health Centre (RI-MUHC) and McGill University. The meta-analysis, which compared studies worldwide, showed that the saliva HIV test, OraQuick HIV1/2, had the same accuracy as the blood test for high-risk populations. The test sensitivity was slightly reduced for low risk populations... (Source: Health News from Medical News Today)

Rapid Oral HIV Test Has Disadvantages Rapid Oral HIV Test Has Disadvantages
Wed, 25 Jan 2012 19:10:19 +0100 | Medscape Today Headlines
The rapid point-of-care HIV test applied to oral specimens has a lower positive predictive value in low-prevalence settings than does the test applied to blood specimens. Medscape Medical News (Source: Medscape Today Headlines)

Nonoccupational post‐exposure prophylaxis source tracing: is it really feasible in Australia?
Wed, 25 Jan 2012 05:00:00 +0100 | HIV Medicine
ConclusionWe hypothesize that there are a number of differences between Australia and Switzerland that make source tracing unfeasible in Australia. (Source: HIV Medicine)

Tanzania: Rejected HIV Test Kits Doubted Since 2007
Tue, 24 Jan 2012 08:57:49 +0100 | AllAfrica News: HIV----- and STDs
Daily News (Dar es Salaam)-REPORTS have emerged that a deal to import and supply HIV Test kits manufactured by South Korean firms that were later found to be defective was questionable since 2007. (Source: AllAfrica News: HIV----- and STDs)

Saliva HIV test passes the grade
Tue, 24 Jan 2012 05:00:00 +0100 | EurekAlert! - Social and Behavioral Science
(McGill University Health Centre) A saliva test used to diagnose the human immunodeficiency virus (HIV), is comparable in accuracy to the traditional blood test, according to a new study. The meta-analysis, which compared studies worldwide, showed that the saliva HIV test had the same accuracy as the blood test for high-risk populations. The study, published in this week's issue of the Lancet Infectious Diseases has major implications for countries that wish to adopt self-testing strategies for HIV. (Source: EurekAlert! - Social and Behavioral Science)

Rapid HIV Test Results Better With Blood (CME/CE)
Mon, 23 Jan 2012 22:43:13 +0100 | MedPage Today State Required CME
(MedPage Today) -- A rapid HIV test gives slightly less exact results when used with oral samples than with blood samples, researchers reported. (Source: MedPage Today State Required CME)


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