HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

32

Transcript of HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

Page 1: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.
Page 2: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

HIV diagnosis (general) Immunoassays NAT (PCR)

10 10 10

20 20 20

30 30 30

40 40 40

50 50 50

Page 3: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

HIV diagnosis (general)

• Serologic tests for HIV infection are based upon detection of IgG antibodies against HIV-1 antigens in serum

Page 4: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

HIV diagnosis (general)

• Yes but not only IgG

Page 5: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

HIV diagnosis (general)

• HIV-specific IgG antibodies appear 6 to 12 weeks following HIV infection in the majority of patients

Page 6: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

HIV diagnosis (general)

• Yes

Page 7: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

HIV diagnosis (general)

• HIV-specific IgG antibodies appear by six months in all HIV infected patients

Page 8: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

HIV diagnosis (general)

• HIV-specific IgG antibodies appear by six months in 95 percent of patients

Page 9: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

HIV diagnosis (general)

• Name 2 of the most specific tests to diagnose HIV

Page 10: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

HIV diagnosis (general)

• Viral culture• NAT (PCR)

Page 11: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

HIV diagnosis (general)

• Explain the difference between an HIV EIA test and an HIV ELISA test

Page 12: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

HIV diagnosis (general)

• EIA: conjugated HIV antigens on the plate not “sandwich method”; 3rd and 4th generation are “sandwich methods”;

Page 13: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

Immunoassays-10

• The standard screening assay for detecting antibodies to HIV is an enzyme immunoassay (EIA). A confirmatory Western blot is performed if the screening test is positive to exclude a false positive test.

Page 14: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

Immunoassays-10

• Yes

Page 15: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

Immunoassays-20

• The most common cause of a false negative HIV antibody test in a high-risk patient is that the assay is being conducted during the "window period" of acute HIV infection prior to seroconversion

Page 16: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

Immunoassays-20

• Yes

Page 17: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

Immunoassays - 30

• False negative HIV antibody tests have been reported among participants in HIV vaccine trials

Page 18: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

Immunoassays - 30

• False: Positive HIV antibody tests have been reported among participants in HIV vaccine trials.

Page 19: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

Immunoassays - 40

• An AA patient from Cameroon presents with acute febrile illness, skin rash and lymphadenopathy 3 weeks after a high risk exposure. What tests should you order?

Page 20: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

Immunoassays - 40

• At least second generation immunoassay and also NAT testing for HIV-2

Page 21: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

Immunoassays - 50

• The patient with an indeterminate result with an HIV rapid test should have repeat testing in one to two months with

a)rapid serologiesb)Standard serologiesc) Rapid OR standard serologies

Page 22: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

Immunoassays - 50

• C: The patient with an indeterminate result should have repeat testing in one to two months with rapid or standard serologies PLUS viral NAT

Page 23: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

NAT (PCR)- 10

• The major limitations of these assays include cost, the requirement for venipuncture, and time interval between sample collection and test results

Page 24: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

NAT (PCR)- 10

• Correct

Page 25: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

NAT (PCR)- 20

• The viral NAT should always be used to diagnose acute HIV infection

Page 26: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

NAT (PCR)- 20

• Only if there is clinical suspicion

Page 27: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

NAT (PCR)- 30

• Quantitative HIV RNA is the preferred test for staging and therapeutic monitoring

Page 28: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

NAT (PCR)- 30

• Correct

Page 29: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

NAT (PCR)- 40

• A HIV-infected mother on ART delivers a baby. Which test will best rule out HIV infection in the baby?

• A) RNA qual PCR• B) DNA PCR• C) 4th generation immunoassays• D) Neither of the above. The baby will need

long term follow up with serial tests

Page 30: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

NAT (PCR)- 40

• B

Page 31: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

NAT (PCR)- 50• An AA patient from Cameroon presents with acute

febrile illness, skin rash and lymphadenopathy 3 weeks after a high risk exposure. What tests should you order?

• a) 4th or 3rd generation immunoassay• b) a + standard HIV PCR available in the clinical lab• C) a+ contact reference lab for appropriate PCR

testing • D) None of the standard tests will rule out

completely the possibility of HIV infection

Page 32: HIV diagnosis (general) ImmunoassaysNAT (PCR) 10 20 30 40 50.

NAT (PCR)- 50

• D