HIV Tests

The HIV test is a special examination of the blood that detects infection with the HIV virus, which can lead to AIDS.

HIV infection – AIDS

AIDS is a disease of the immune system that worries many people. It is caused by the HIV virus, but infection (contagion) does not immediately cause AIDS. AIDS is the last stage of HIV infection, caused by the complete failure of the immune defense. The HI virus is transmitted through direct blood contact. The following routes of infection are possible:

  • Unprotected sexual intercourse – without a condom – is one of the main causes of infection.
  • Infected blood – In the past, the virus could be transmitted through contaminated blood. Nowadays, all blood donations are tested for the HI virus and the risk is greatly reduced in Germany, it is only 1:1,000,000 in Germany.
  • Intrauterine or perinatal infection from mother to fetus, i.e. transmission from a pregnant, infected mother to the unborn or “around birth” (about 30%).
  • Shared use of needles – e.g., drug addicts – HIV can be easily transmitted through this
  • Injuries, e.g. needlestick injury – Especially among health care workers: The risk of infection in a needle stick injury with virus-positive blood is up to 0.3%.

Note!Smokers can become infected with HIV up to a factor of 3.5 more easily, which researchers found when evaluating 6 individual studies.

The procedure

The current HIV screening test is an Ag-Ak combination test: Determination of antibodies (Ak) to HIV type 1/2 and HIV 1-p24 antigen.According to DVV recommendations, the test is performed as a two-step diagnostic: serologic screening followed by confirmatory diagnostics by antibody-based test systems such as Western blot (Westernblot; also immunoblot) and/or by HIV NAT (nucleic acid amplification test = polymerase chain reaction (PCR) assay: direct detection of viral nucleic acid in blood). If HIV infection is transmitted, the combined antibody-antigen screening test will be positive after 6 weeks at the latest. Note: The patient must consent before the HIV test is performed (documented consent). HIV testing is performed when there is an increased risk of HIV infection:

  • Professional sex workers
  • Men who have sex with men (MSM)
  • Promiscuity/frequently changing partners (>5 partners per year with anal/vaginal penetrative sex).
  • Drug addicts
  • Migrants from high-risk areas (e.g. countries of sub-Saharan Africa).

Furthermore, HIV testing is required in the following cases:

  • Couples or women who wish to have children (maternity guidelines).
  • Couples with a desire for unprotected sexual intercourse.
  • After unprotected sexual intercourse with unknown partners.
  • After blood transfusions, especially if they were performed abroad
  • Prolonged fever, weight loss or night sweats (night sweats).
  • Persistent chronic fatigue
  • Unclear skin tumors and lymphadenopathy (lymph node enlargement).
  • Prolonged dry cough along with dyspnea (shortness of breath).
  • Persistent diarrhea (diarrhea).
  • In the case of a new diagnosis of a sexually transmitted disease (gonorrhea, syphilis, lymphogranuloma venereum, ulcus molle, chlamydia, hepatitis B / if necessary also hepatitis A and hepatitis C, human papilloma virus (HPV), herpes simplex II, trichomonads, crabs, granulomata inguinale); furthermore, in the presence of tuberculosis and in the case of a herpes zoster infection of a younger patient.
  • For safety and as a donor or as a recipient in blood, sperm and organ donations.

Indicator diseases

Indicator diseases, i.e., diseases associated with an increased likelihood of HIV infection (HIV prevalence > 0.1%):

  • Sexually transmitted infections
  • Hepatitis (liver inflammation) B/C
  • Herpes zoster (shingles)
  • Mononucleosis-like clinical picture
  • Seborrheic dermatitis (oily-scaly inflammation of the skin)/exanthem (inflammatory rash).
  • Cervical or anal carcinoma or dysplasia (cervical and anal cancer).
  • Lymphoma (cancers of the lymphatic system).
  • Unexplained leukopenia (decreased white blood cell count)/thrombocytopenia (decreased platelet count)

Benefits

The HIV test provides you with evidence of whether you have been infected.The newly used screening tests, which additionally look for specific viral components (p24 antigen) in the blood, detect HIV infection six weeks after transmission of HIV infection.The HIV test enables a quick, more effective start of treatment for HIV infection if the test result is positive.You not only protect yourself, but also your partner. Important Note: If you have tested HIV self-test with saliva or blood from your fingertip, it is required that you have a positive result confirmed by another test at a doctor’s office or clinic.