HIV Test | Shim Clinic, Singapore | HIV STD TESTING TREATMENT™

HIV Test | Shim Clinic, Singapore | HIV STD TESTING TREATMENT™: HIV screening test/check clinic, Singapore. Private and confidential service. Definitions, references, and latest news.

Description

Table of Contents

• HIV
• HIV Symptoms
• HIV Window Period
• HIV Screening / HIV Test / HIV Check
  • 3rd generation HIV ELISA Test (HIV Antibody Test)
    • 20 minute HIV Rapid Test: OraQuick® HIV Oral Test / HIV Saliva Test
    • 1-2 days HIV Blood Test
  • 4th generation HIV ELISA Test (HIV Antibody Test + HIV p24 Test)
    • 20 minute HIV Rapid Test: HIV Combo Test
    • 1-2 days HIV Duo Test
  • HIV PCR (polymerase chain reaction) NAT (nucleic acid test)
    • HIV DNA Test
    • HIV RNA Test
  • HIV Western Blot Test (for HIV confirmation only)
• HIV Test Kit
• HIV Risk
• HIV Prevention / HIV PEP (Post-Exposure Prophylaxis)

HIV is the abbreviation for the human immunodeficiency virus, which causes the acquired immunodeficiency syndrome

HIV symptoms which may present in acute HIV infection:

• Fever
• Malaise
• Myalgia
• Rash
• Headache
• Night sweats
• Sore throat
• Lymphadenopathy
• Arthralgia
• Nasal congestion

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.

• 4 weeks after exposure, a negative 4th generation HIV ELISA Test "is very reassuring / highly likely to exclude HIV infection."
• 12 weeks after exposure, a negative 3rd generation HIV ELISA Test "would definitively exclude HIV infection."

• BASHH Statement on HIV window period 15 MARCH 2010

1. 1st generation: HIV-1 IgG antibody
2. 2nd generation: HIV-1 & HIV-2 IgG antibodies
3. 3rd generation: HIV-1 & HIV-2 IgG & IgM antibodies
   • 3 month HIV window period
4. 4th generation: HIV-1 & HIV-2 IgG & IgM antibodies and HIV p24 antigen
   • 1 month HIV window period

• 1st, 2nd, 3rd, and 4th Generation HIV Antibody ELISA Tests

• Alere™ Determine™ HIV-1/2 Ag/Ab Combo test
  • 4th generation HIV ELISA test.
  • 1 month HIV window period.
  • Recommended when exposure was 1 month or more ago
  • Fingerprick blood sampling
  • Cost/price is S$180/=.
• OraQuick® Rapid HIV-1/2 Antibody Test
  • 3rd generation HIV ELISA test.
  • 3 month HIV window period.
  • Recommended when exposure was 3 months or more ago
  • HIV oral test / HIV saliva test or Fingerprick blood sampling
  • Cost/price is S$60/=.

Note: If the clinic attendance is only for the HIV rapid test, then consultation fees are not added.

References

• 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
• WHO Prequalification of Diagnostics Programme PUBLIC REPORT Product: Alere Determine HIV-1/2 Ag/Ab Combo
• OraQuick ADVANCE® Rapid HIV-1/2 Antibody Test Customer Letter

• HIV DNA (deoxyribonucleic acid) PCR(polymerase chain reaction) NAT (nucleic acid test)
• HIV RNA (ribonucleic acid) test PCR(polymerase chain reaction) NAT (nucleic acid test)

Estimated HIV transmission risk per exposure for specific activities and events

Activity	Risk-per-exposure
Vaginal sex, female-to-male, studies in high-income countries	0.04% (1:2380)
Vaginal sex, male-to-female, studies in high-income countries	0.08% (1:1234)
Vaginal sex, female-to-male, studies in low-income countries	0.38% (1:263)
Vaginal sex, male-to-female, studies in low-income countries	0.30% (1:333)
Vaginal sex, source partner is asymptomatic	0.07% (1:1428)
Vaginal sex, source partner has late-stage disease	0.55% (1:180)
Receptive anal sex amongst gay men, partner unknown status	0.27% (1:370)
Receptive anal sex amongst gay men, partner HIV positive	0.82% (1:123)
Receptive anal sex with condom, gay men, partner unknown status	0.18% (1:555)
Insertive anal sex, gay men, partner unknown status	0.06% (1:1666)
Insertive anal sex with condom, gay men, partner unknown status	0.04% (1:2500)
Receptive fellatio	Estimates range from 0.00% to 0.04% (1:2500)
Mother-to-child, mother takes at least two weeks antiretroviral therapy	0.8% (1:125)
Mother-to-child, mother takes combination therapy, viral load below 50	0.1% (1:1000)
Injecting drug use	Estimates range from 0.63% (1:158) to 2.4% (1:41)
Needlestick injury, no other risk factors	0.13% (1:769)
Blood transfusion with contaminated blood	92.5% (9:10)

Sources: vaginal sex;¹ anal sex;² fellatio;^{3 2} mother-to-child;⁴ other activities.⁵

References

1. Boily MC et al. Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies. Lancet Infect Dis 9(2): 118-129, 2009
2. Vittinghoff E et al. Per-contact risk of human immunodeficiency virus transmission between male sexual partners. American Journal of Epidemiology 150: 306-311, 1999
3. Del Romero J et al. Evaluating the risk of HIV transmission through unprotected orogenital sex. AIDS 16(9): 1296-1297, 2002
4. Townsend C et al. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000-2006. AIDS 22: 973-981, 2008
5. Baggaley RF et al. Risk of HIV-1 transmission for parenteral exposure and blood transfusion. AIDS 20: 805-812, 2006
6. HIV & AIDS Information :: How transmission occurs - Estimated risk per exposure

Estimated per-act risk for acquisition of HIV, by exposure route*

References

• Estimated per-act risk for acquisition of HIV, by exposure route
• Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV in the United States

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.

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

1. less than 72 hours has elapsed since exposure;
   and
2. the exposed individual is not known to be HIV infected;
   and
3. the person who is the source of exposure is HIV infected or has unknown HIV status;
   and
4. mucous membrane or non-intact skin was exposed to a potentially infectious body fluid;

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.

• Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV in the United States
• HIV postexposure prophylaxis: Who should get it?

• Lamivudine/zidovudine (Combivir®)
  • Lamivudine (3TC®) (NRTI)
  • Zidovudine (ZDV) (NRTI)
• Lopinavir/ritonavir (Kaletra®)
  • Lopinavir (ABT-378) (PI)
  • Ritonavir (Norvir®) (PI)

• Post-exposure prophylaxis to prevent HIV infection : joint WHO/ILO guidelines on post-exposure prophylaxis (PEP) to prevent HIV infection.

TORCH

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

Note: If the clinic attendance is only for the HIV rapid test, then consultation fees are not added.

References

• HIV test images
• HIV test - Wikipedia, the free encyclopedia
• HIV test: Definition from Answers.com
• HIV test - definition of HIV test in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia.
• WHO | WHO and HIV
• CDC HIV

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