Should HIV testing be required?

HIV Testing

• Why is it that after nearly 20 years, modern medicine has yet to develop a test that actually looks for the HIV virus, let alone being able to culture the HIV virus? We all know that the current testing for HIV is done by looking for the anti-bodies for HIV, not the virus itself. You should also know that both the ELISA and Western blot antibody tests have no GOLD Standardization. Since when to we give people chemotherapy strength drugs based on antibody tests. I know that doctors use the Amplicore "Viral Load Test" to test the amount of virus that's in the body, but the Viral Load test isn't FDA approved and is said to only look for about 3% of the proteins that make up the HIV virus. Also, the package insert distributed with the Amplicore test says... "this test is not to be used as a diagnostic tool to detect the HIV virus or to determine the condition of AIDS”?

• Answer:

  Direct HIV testing is not only in practice, but it is also being 'taught' to college level students involved in virology. A studyguide for the 400 level course midterm reads (link below). I've listed only part of the answer to comply with copyright of the original page, please click on the link for the full explanation of direct HIV testing. "Question: You are given a blood sample of a patient who may have been exposed to human immunodeficiency virus (HIV). What would be an appropriate way to test whether or not this patient has indeed been exposed? Describe the steps involved in your approach. It would also be possible to test for HIV directly in the patient's blood cells using some method to detect HIV-specific nucleic acid sequences. For example, you might look for HIV- specific mRNA by Northern blot, or for HIV-specific DNA by Southern blot or the polymerase chain reaction." Also, Dr. Patrick Dixon discusses in his 1994 book entitled, "The Truth About AIDS" states: "It is possible to test for HIV directly, not waiting for antibodies to develop. This method looks for viral genes---the DNA instructions that the virus inserts into white cells to hijack them into virus factories. A special chemical reaction is used called PCR (polymerase chain reaction), which can multiply a million copies of viral DNA in three hours, and combined with other equipment can detect as little as one piece of viral DNA in ten microlitres of blood. The test has been useful in some situations to detect possible infection far earlier than antibody tests. More than 90% of antibody positive people also test positive by PCR, but not all. The technique is extremely sensitive to cross-contamination from previous samples. It is very easy to get false positive results. Viral culture is another method of testing, where attempts are made to obtain HIV from white cells. It can detect 50% of HIV-infected children at birth, unlike antibody testing. In conclusion then, HIV testing is now very accurate indeed, although the initial test result always needs to be confirmed." Please remember that these two procedures were experimental at the time of his book (1994) and have had 8 years to be developed, refined, and eventually made common place enouhg that it is taught in college level courses. So the question you may ask next is, "Why isn't HIV-direct testing more prevalent?" The answer to that question is money. These tests are very difficult to run, and are multi-step as described briefly on the two pages above. It is not economically or logistically feasible to offer this test as a first option, although I'm sure some labs would run this test if requested by a hospital/clinic. Additional Links Virology 442 course midterm study guide at University of Waterloo: http://www.science.uwaterloo.ca/course_notes/biology/biol442/answ4.html Link to excerpt from Dr. Patrick Dixon's book (copy and paste URL into browser or you'll have to click manually on "How accurate is testing for HIV": http://www.globalchange.com/ttaa/ttaa%205.htm#Q.´How accurate is testing for HIV? Search Strategy: "test for HIV directly" on google: ://www.google.com/search?q=%22test+for+HIV+directly%22 Thank you for the opportunity to answer your question, if you require more information, please clarify the question, or if you find this answer satisfactory, please feel free to rate it. Thank you! skermit-ga