Diagnosis of HIV

Even though the management of HIV has improved dramatically over the last few years, there is still no cure. People are often afraid to be tested for HIV and so delay the test for a long time out of fear. Being diagnosed with HIV infection is not a death sentence. There are various human rights issues when it comes to diagnosing HIV. Patients are entitled to confidentiality and counselling during their HIV testing. Informed consent should be obtained from someone before testing them for HIV.

Health Care workers are encouraged to perform pre-test and post-test counselling to educate the patient about HIV. Counselling is also good to prevent depression in a patient who is newly diagnosed with HIV.

There are several different tests which can be used to diagnose HIV. Sometimes HIV can be suspected from clinical examination alone but needs to be confirmed with special investigations. It is encouraged that the patient returns for a repeat test in 2 months time because people with HIV can test negative during the window period of the virus. The window period is usually the first month or 2 after contracting the virus.

The diagnosis of HIV is briefly discussed:

  • Medical History
    Medical history should include any symptoms the patient may be experiencing, any current or previous conditions which are present and any medication which the patient is currently taking. It is also of important for the doctor to enquire about the patient’s sex life and any intravenous drug abuse.
  • Medical Examination
    The medical examination should include a general examination and a brief systemic examination. The doctor should feel for lymph nodes and examine the skin of the patient. The mouth is examined for any signs of candida.
  • Rapid finger test

    Rapid finger test

  • Rapid Finger-prick HIV test
    Rapid HIV diagnostic kits are available which can accurately diagnose HIV infection by using a drop of blood from a patient. This is similar to testing someone’s glucose. A small prick is made in a finger using a lancet or small needle. The drop of blood is then dropped on the spot indicated and a small amount of reagent is then applied to the blood. HIV can be diagnosed in this way within 5 minutes.


    Blood test

  • Blood test for HIV
    Blood can be drawn to be tested for HIV. There are various tests that can be performed on blood to diagnose HIV. The HIV ELISA test tests for HIV antibodies in the blood. Antibodies are not present immediately and HIV ELISA test may not detect early HIV infection. HIV viral load can also be done on blood. A viral load is also used to determine the effectiveness of treatment. A HIV PCR can also be done on a blood sample. This test is sometimes considered more accurate than an ELISA test. The CD4 count is also determined by drawing blood. HIV is not the only condition which lowers CD4 count so therefor this test should not be the only test used to diagnose HIV. CD4 count is a good indication of disease progression.

    Rapid oral test

    Rapid oral test

  • Rapid Oral Testing
    Tests using saliva can also be used to test for HIV. These tests are non-invasive and very easy to use. They are not as accurate as other tests. A finger prick test or a blood test is used to confirm positive results.