AIDS Tests Health Article

AIDS serology in children

Children born to HIV-infected mothers may acquire the infection through the mother's placenta or during the birth process. Public health experts recommend the testing and monitoring of all children born to mothers with HIV. Diagnostic testing in children older than 18 months is similar to adult testing, with ELISA screening confirmed by Western blot. Younger infants can be diagnosed by direct culture of the HIV virus, PCR testing, and p24 antigen testing. These techniques allow a pediatrician to identify 50% of infected children at or near birth, and 95% of cases in infants three to six months of age.

Preparation

Preparation and aftercare are important parts of AIDS diagnostic testing. Doctors are now advised to take the patient's emotional, social, economic, and other circumstances into account and to provide counseling before and after testing. Patients are generally better able to cope with the results if the doctor has spent some time with them before the blood test explaining the basic facts about HIV infection and testing. Many doctors now offer this type of informational counseling before performing the tests.

Aftercare

If the test results indicate that the patient is HIV-positive, he or she will need counseling, information, referral for treatment, and support. Doctors can either counsel the patient themselves or invite an experienced HIV counselor to discuss the results of the blood tests with the patient. They will also assess the patient's emotional and psychological status, including the possibility of violent behavior and the availability of a support network.

Risks

The risks of AIDS testing are primarily related to disclosure of the patient's HIV status rather than to any physical risks connected with blood testing. Some patients are better prepared to cope with a positive diagnosis than others, depending on their age, sex, health, resources, belief system, and similar factors.

Normal results

Normal results for ELISA, Western blot, IFA, and PCR testing are negative for HIV antibody.

Normal results for blood cell counts:

• WBC differential: Total lymphocytes 24-44% of the white blood cells.
• Hematocrit: 40-54% in men; 37-47% in women.
• T cell lymphocytes: 644-2200/mm³, 60-88% of all lymphocytes.
• B cell lymphocytes: 82-392/mm³, 3-20% of all lymphocytes.
• CD4+ lymphocytes: 500-1200/mm³, 34-67% of all lymphocytes.

Abnormal results

The following results in AIDS tests indicate progression of the disease:

• Percentage of CD4+ lymphocytes: less than 20% of all lymphocytes.
• CD4+ lymphocyte count: less than 200 cells/mm³.
• Viral load test: Levels more than 5000 copies/mL.
• -2-microglobulin: Levels more than 3.5 mg/dL.
• P24 antigen: Measurable amounts in blood serum.

BOOKS

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PERIODICALS

Freedberg, Kenneth A., and Samet, Jeffrey H. "Think HIV (HIV Testing)." Archives of Internal Medicine (September 27, 1999): 1994

Kaplan, Edward H., and Satten, Glen A. "Repeat Screening for HIV: When to Test and Why." The Journal of the American Medical Association. (July 19, 2000): 285.

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Weinhardt, Lance S., et al. "Human Immunodeficiency Virus Testing and Behavior Change." Archives of Internal Medicine. (May 22, 2000): 1538.

Woehrle, Theresa A., and Branson, Bernard. "New Tests for Detecting HIV Infection." The Western Journal of Medicine. (December 1998): 371-372.