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Early Symptoms of HIV

August 05, 2009

One of the commonest recurring questions put to us at Nexus Laboratories, is to do with the very early symptoms of HIV following an often minor sexual indiscretion.

Early HIV symptoms are very like those of any other infectious illness, making it extremely difficult, if not impossible, to identify an early infection with HIV symptoms alone. The commonest symptoms are vague and comprise of headache, rash, fever, sweats, sore throat, abdominal pain, nausea, vomiting, and swollen glands in neck, armpits and groins.

These symptoms will appear in approximately - and it is a very rough approximation - 50-80% of newly HIV infected people. Very many of these will experience mild or almost non existent symptoms, with the remainder having severe illness requiring medical attention. Most of the people have had an innocuous sexual exposure with no realistic possibility at all of acquiring HIV from it. Despite that, the level of anxiety and distress caused is often massively disproportionate.

Early HIV infection is always best tackled by having one of a range of HIV tests now commonly available. There are now very compelling reasons to have an HIV test as early as possible. Firstly, simply knowing your HIV status will allow you to make adjustments to your lifestyle to protect yourself against further complications. For example, getting plenty of good quality rest, taking vitamin supplements, drinking less alcohol, eating a healthy diet, stopping or reducing recreational drug use are all some of the immediate measures an individual can take to help preserve health and strength. Secondly, knowing your HIV status early allows, if HIV positive to measure where exactly your immune status is through baseline HIV monitoring tests. Many people fear the early introduction of medications, but in fact medications are not needed in the short or even medium term for many people. Thirdly, knowing you are HIV positive allows you to take decisions to protect yourself from further infections which might reduce your immunity further and also to protect others you might care about.

HIV testing has become very sophisticated and allows for very early diagnosis.

Using an appropriate mix of HIV tests will allow for reliable diagnosis within the first few weeks of possible infection.

HIV PCR testing will allow for diagnosis of HIV 1 from around ten days post exposure. There are some downsides associated with the test. These include a) the cost as it is not a routine test b) the fact that it looks for HIV 1 only. This in itself is not too much of a problem in most countries as HIV1 is by far the most common type c) it may take a few days to return to the doctor requesting - meaning that although the test can be done at 10 days it may take up to 5 working days to be returned d) it has an overall "accuracy" of around 96-99% with false positives and negatives occuring.
HIV DUO testing allows for reliable diagnosis of HIV 1 and 2 from 28 after a possible exposure. The test detects HIV 1 and 2 and also a core protein of HIV 1, the p24 antigen. This will give an accurate result after 28 days with an overall accuracy of 99.89%. The advantages are that it is quick, easy to perform, and the return times form the laboratory should be short - of the order of 4 hours or so.
HIV Antibody testing is still the standard testing method worldwide, the Sexual Health testing sector being relatively slow to embrace new methodologies. Modern 4th generation antibody tests are very sensitive and will allow often for reliable results after approximately 6 weeks or so, although most of these tests remain licensed for use after three months.
Western Blot HIV testing. This is a commonly used test to confirm an initial indeterminate or positive test result from eg an HIV DUO test or an HIV antibody test

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