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Symptoms of HIV and AIDS

There are numerous symptoms associated with "HIV Infection" and "AIDS" but some of the information about them seems arbitrary or contradictory.

The quotes are classified as:

Adult HIV Infection Definition

“Of 4,450 patients referred, 51 were subsequently determined to be HIV-uninfected by undetectable plasma HIV-1 RNA, CD4 positive lymphocyte count within normal limits, and repeat ELISA.”
Maddux DE et al. Misdiagnosis of HIV infection: implications for universal testing. AIDS. 2008 Feb 19;22(4):546-7.
“Diagnosis of HIV infection [in adults and children over 18 months old] is made with: positive HIV antibody testing (rapid or laboratory based EIA). This is usually confirmed by a second HIV antibody test (rapid or laboratory based EIA) relying on different antigens or of different operating characteristics. [OR] Positive virological test for HIV or its components (HIV-RNA or HIV-DNA or Ultrasensitive HIV p 24 antigen) confirmed by a second virological test obtained from a separate determination.”
Revisions to WHO HIV and AIDS case definitions and classification of HIV related disease. WHO EMRO National Programme Manager Meeting. Amman, Jordan. 2006 Jun
“A total of 880 534 donations of whole blood and platelets collected between January 8, 1999, and August 8, 2000, and 791 639 units between January 1, 2001, and July 4, 2002 in the Inland region of SANBS were analyzed. All donations were…screened for HIV-1 and 2 antibodies, p24 antigens…Repeatedly reactive samples for HIV-1 p24 antigen were confirmed by neutralization and for HIV-1 and 2 antibody were confirmed using a second enzyme-linked immunoassay (EIA). Human immunodeficiency virus Western blotting was not routinely performed”
Heyns Adu P et al. Prevalence of HIV-1 in blood donations following implementation of a structured blood safety policy in South Africa. JAMA. 2006 Feb 1;295(5):519-26.
“All donations were voluntary, nonremunerated, and screened for HIV-1 and 2 antibodies, p24 antigens, hepatitis C antibody, and hepatitis B surface antigen, and syphilis. Repeatedly reactive samples for HIV-1 p24 antigen were confirmed by neutralization and for HIV-1 and 2 antibody were confirmed using a second enzyme-linked immunoassay (EIA). Human immunodeficiency virus Western blotting was not routinely performed.”
Heyns Adu P et al. Prevalence of HIV-1 in blood donations following implementation of a structured blood safety policy in South Africa. JAMA. 2006 Feb 1;295(5):519-26.
“All reactive rapid HIV test results require confirmatory testing. CDC…protocols recommend 1) confirmation of all reactive rapid HIV test results with either Western blot (WB) or immunofluorescent assay (IFA), even if an enzyme immunoassay (EIA) screening test is negative, and 2) follow-up testing for persons with negative or indeterminate confirmatory test results, with a blood specimen collected 4 weeks after the initial reactive rapid test result. [this introduces two biases in favor of positive test results. A single negative ELISA is normally considered to be a true negative and a second round of confirmatory testing gives another chance for a positive confirmatory test, without a similar chance when the first confirmatory test is positive]
Notice to Readers: Protocols for Confirmation of Reactive Rapid HIV Tests. MMWR. 2004 Mar 19;53(10):221-2.
“We used two independent enzyme immunoassays [ELISA] to establish HIV-1 status (Wellcozyme HIV-1 recombinant VK 56/57, Murex Biotech, Dartford, UK; and Recombigen HIV-1/2, Trinity Biotech, Galway, Ireland) with set algorithms. Samples discordant on enzyme immunoassay and all first time positive samples were tested by western blot (Cambridge Biotech HIV-1 western blot, Calypte Biomedical, Rockville, MA, USA). Reproducibility of results from this laboratory was achieved by rigorous internal quality assurance, by use of several positive and negative control samples on each enzyme immunoassay plate, and by a computerised assessment of coefficient of variance of these samples’ optical densities with a cutoff of 20%. Additional external quality assurance was provided through the US Centers for Disease Control and Prevention model performance evaluation program (CDC-MPEP).”
Mbulaiteye SM et al. Declining HIV-1 incidence and associated prevalence over 10 years in a rural population in south-west Uganda: a cohort study. Lancet. 2002 Jul 6;360(9326):41-6.
“Figure on page 12 (Interpretation of HIV testing): CT=Confirmatory Test (WB, Immunoblot, Radioimmunoprecipitation, Radioimmunfluorescence)

Negative(or window period): ELISA- OR ELISA+, 2xELISA- OR ELISA+,ELISA+ & ELISA+/-, CT-

Indeterminate: ELISA+,ELISA+ & ELISA+/-, CT?

Positive: ELISA+, ELISA+ & ELISA+/-, CT+”

Counselling guidelines for HIV testing. CMA. 1995

Courtesy Alberta Reappraising AIDS Society, December 7, 2012.

© Copyright December 7, 2012 by Rethinking AIDS.