HIV Tests Explained for Clinicians

An infectious diseases specialist explains HIV testing. What kind of HIV tests are available, how should we use them, and when? How do laboratory-based tests compare to point-of-care HIV tests? What is the sensitivity and specificity of different HIV tests? What is the window period for each test, and how does that influence HIV testing algorithms? What if we want to exclude HIV infection? When should we repeat the test or use another one? How do we approach possible acute HIV infection versus chronic HIV infection or AIDS? As always, this video is primarily intended for clinicians, medical professionals, and students. I highly recommend you follow the links to the research articles I used as resources for this video. You will learn a lot. Good luck!

DISCLAIMER: Please, always keep in mind that my videos are intended for educational purposes only. The content of my videos is NOT medical advice. I do not practice medicine over the internet. If you are a patient and have any questions about your health, please talk to your doctor.

CHAPTERS:
00:00 What do HIV tests detect?
00:38 The typical progression of HIV infection
01:02 When HIV RNA, p24 antigen, and anti-HIV antibodies become detectable
02:47 HIV testing algorithms, HIV combo tests, confirmatory tests, HIV RNA PCR
05:44 Point-of-care HIV tests
07:02 Window periods for different HIV tests (HIV RNA PCR, HIV combo tests, HIV antibody tests): What do they really mean?

REFERENCES & RECOMMENDED READING:
3. HURT CB, NELSON JAE, HIGHTOW-WEIDMAN LB, MILLER WC. Selecting an HIV Test: A Narrative Review for Clinicians and Researchers. Sex Transm Dis. 2017 Dec;44(12):739–46.

[clinicaltips]

I want to remind everyone that my videos are for educational purposes only. Of course, everyone is welcome to watch, but the information I present is most useful for junior doctors, nurses, and students. As I stated in the description of every video and on my channel homepage, none of this is medical advice for patients. I don't practice medicine over the internet. If you are a patient and have any questions about your health, please get in touch with your doctor.

[sanbetski]

this channel is underrated. thank you for the review! more power to you

[anonymxjxj]

I had a false positive. I know my friend did too. It can't be so rare... in fact 85% of positives are coming back as negative on confirmatory tests.

[brasileiro]

Doctor window period is 30 days in Brazil, maximum 60 days.

[jamesharris]

Hi @clinicaltips8926, do you know what the sensitivity of the RNA PCR test is at 17 days, or 21 days? The only study I see states at 12 days 50% of HIV positives are detected. So that would be a sensitivity of 50%, like you suggest in video (median time of 12 day). I'm wondering if it's worth waiting another week to test.

It's confusing because online there are some confusing statistics (people quoting average sensitivity across all time periods and making it out like that would be the sensitivity at 10 days).

[sanjaydhendrix]

after 38 days I have tested rna pcr test and after 49 days again I have tested pls tell me that it's conclusive... And also same date I have tested combo test both are non detected.... please tell me the truth

[bsfbestshortfilmsonyoutube]

Can this test kit be used after 2 years since my last HIV test ? would this test kit be still able to detect hiv antibodies after 2 years since my last hiv test ? would it be accurate ? if It reads NEG or POZ after 2 years ? everything i read says use the test kit in window period of 3 months to 90 days but no mention how long afterwards ?

[josesoares]

wish you are right in all your studies

[BhadraBrown]

I have tested negetive for hiv duo eclia after 2 months and 3 months and western blot negative after 4 months of potential exposure... But symtomps persists which could be related. Do i need further tests?

[thesoulofpeacemusic]

Hi drI'm glad you make a lot of positive videos, I want to tell you my case and I will be very happy if you answer me. I was exposed to the virus from an HIV positive patient with a nosebleed. he is on art. I was tested on day 11 with a PCR test <75 copies and it was negative. on day 21, 32, 45, 62, 81, 95 with 4 generations, all negative. on day 107, an elisa test was negative, and on month 5, a semi-quantitative aces test was non-reactive with a result of 0.17. I'm in a big panic. I don't feel well. I am very stressed. your opinion will mean a lot to me. I am asking for an answer.

[IyanArdiansyah-lszz]

I'm going through the same thing, and have many similar symptoms. In the next few days I will do a test on the 45th day, this is really tough

[joshhall]

A lot of talkin but he isn’t going over the window period to get tested I noticed. He said 4 week is too soon to get tested, but I don’t think that’s true as symptoms show up 4-6 weeks. And the window period is 18-90 days.

[ilfrecchio]

Is there a possibility of false negative test after 41 days with a 4th gen test?

[LinaLizie]

Why should an HIV- antibody positive test result always be confirmed with a second confirmatory test?

[PwHighlights]

P24 antigen start declining after 4 weeks then doing p24 test after 45 days how conclusive?

[chenzeng]

Sir ..if i test pcr rna hiv 15 days after exposure..i am safe or not? Please reply this..i am very scared😭😭

[realworld]

I have tested 4 generation ELA test after 52 days of exposure wich is negative but i have all symptoms so what should i do now 😢 i am so sad please help me some one who knows everything about this test and my situation

[adonielcastillo]

I leterally had practice risk 2 years ago i got tested and it and the results for hiv and vdrl were" no reactive" or negative should i get test again because my doctor told me to do the test for a prostatitis symptoms i am having which i have been having for 1 year already

[lanoyee]

thank you so much for this great video. It helped me a lot to understand the concept of diagnosis HIV.

[felipecb]

The six-month thing is too old and the current guide for detecting HIV is no longer used, this man is quite outdated. According to the CDC, it only takes four weeks for the fourth generation test and three months for the thirteenth. PLEASE UPDATE.