Educations & Solutions

 

What are the different HIV screening tests available in the United States?

HIV Antibody Testing Options

The Centers for Disease Control and Prevention estimate that between 850,000 and 900,000 Americans are infected with HIV. An estimated 180,000 to 280,000 Americans do not know they are infected, and may continue to engage in behavior that could jeopardize their health, and the health of others.

Testing Programs: Voluntary counseling, testing, and referral programs (CTR) provide people an opportunity to learn their current HIV status, receive counseling about any behavioral changes needed to avoid infection or infecting others, and receive information and referrals to additional prevention programs, medical care or other services.

Confidential HIV Testing means you give your name when getting tested. Only medical personnel or state health departments have access to the test results. You must provide written permission before this information can be revealed to others.

Anonymous HIV testing means that no name is given to the testing center and only you are aware of the results. Anonymous testing is available in 39 states, the District of Columbia and Puerto Rico. Test results are given by randomly assigned numbers at the time of testing.

 

Types of HIV Antibody Tests

There are several HIV antibody tests being used today. All testing options are not available in all areas. Contact your local health department for the tests available in your area.

Standard blood test: This was the first HIV antibody test developed and made available, and is the most widely used. With this test, an initial assay is used (the ELISA), and confirmed using a more specific test (the Western Blot).

Oral mucosal transudate test: This test, an alternative to the standard blood test, uses a specially treated pad placed in a person’s mouth, and gently rubbed between the lower cheek and gum. The pad collects an oral fluid called oral mucosal transudate (OMT). This fluid contains HIV antibodies in an HIV- infected person. This test does not test for HIV in saliva.

Urine HIV antibody test: The urine HIV-1 testing method is a painless, non-evasive option for getting an HIV antibody test. This test uses the urine EIA (ELISA) and urine Western Blot technique to detect HIV antibodies, and is FDA – licensed as an alternative to the blood test system. This test eliminates accidental needle sticks and exposure related dangers, protecting the patient and healthcare worker.

Rapid HIV antibody tests: Where the standard HIV antibody testing procedure requires up to two weeks for results, the rapid test gives results in 5-60 minutes. Currently approved rapid HIV tests only test with blood. Other rapid HIV testing methods are in development. To perform the test, a fingerstick sample of blood is collected from an individual and transferred to a vial where it is mixed with a developing solution.The test device, which resembles a dipstick, is then inserted into the vial. In as little as 20 minutes, the test device will indicate if HIV–1 antibodies are present in the solution. Although the results of rapid screenings will be reported in point–of–care settings, as with all screening tests for HIV, if the OraQuick test gives a reactive test result, that result must be confirmed with an additional specific test.The OraQuick test has not been approved to screen blood donors.

Home Testing Kit: This do–it–yourself test kit uses the same technology as the standard blood test. Individual blood samples are collected at home, and mailed to a laboratory.Test results are provided over the telephone. The serum home testing kit costs between $30 and $45, and is available at many drug stores. Currently there is only one FDA approved home sample collection kit. Home HIV tests for other fluids are in development.

For more information about testing options in your area, contact you local health department or the National STD/HIV/AIDS hotline (1–800–342–2437).The only way to know if you are infected with HIV is by taking an HIV antibody test.

This article was provided by National Association of People With AIDS.
Should I get tested?
Yes. The CDC recommendations which came out in 2006 recommended every person age l3-65 be tested. Some of the people who are at high risk need to be tested more often.
Where can I get tested?
About four to six weeks after you've been exposed to HIV, you will want to test for it with a standard HIV antibody test. You can get this test at anonymous HIV testing sites. You can also get it through your doctor's office, at public health clinics, some AIDS service organizations, and through an in-home collection kit.

A standard antibody test does not look directly for HIV. Rather, it checks for antibodies -- proteins your body makes in response to having HIV. If you have these antibodies, you are considered to be HIV-positive. That means you have HIV, the virus that causes AIDS.

If your result comes back positive, some people take a second test to confirm the result. For some, taking another test eases their doubts about the result. However, labs normally test your blood two different ways to confirm a positive result. So, when you get a positive test result, your blood or saliva has already been tested twice.

If you do not have these antibodies, you are considered HIV-negative. However, it can take up to six months after you've been exposed to HIV for you to develop antibodies. If you test negative, then you should screen again three months and again at six months after the exposure to confirm that you're HIV-negative. You won't know for certain if you are negative until you confirm it with another test after 6 months from the original exposure.

In some cases, the test result may come back indeterminate. Usually this occurs when the test is taken too early after the exposure. When this happens, you should repeat the test awhile later. Rarely, it can take several months before the test gives a definitive answer.

The standard antibody test, however, is not used for newborn babies. It is not reliable in detecting if a baby -- born to an HIV-positive woman -- is infected with HIV. In this case, babies are born with their mother's antibodies, so special tests must be used to tell if a baby is infected.

Depending on where you live, you may have several screening options available to you. It's important that you think about and choose the one that's right for you. HIV screening will be part of your first nPEP visit. You doctor may have rapid testing available, and thus be able to get immediate results. These results can only tell you if you have HIV from a previous exposure. They cannot tell you if you've recently been exposed to HIV and if that has lead to an established HIV infection. The basic HIV screening options are explained below. Other options may be available to you through your doctor or site where you are getting nPEP services.

 

Going to Your Doctor's Office

If you have a doctor that you usually see, you might choose to call for an appointment. He or she can order HIV screening for you. Your doctor will either take a sample of your blood or saliva in the office or send you to a lab to get it done.

The benefit of going to your doctor is that you may already have a good relationship and feel at ease talking to her or him about HIV. The drawback is that he or she may not be well trained in providing counseling before and after testing. A well-trained counselor can help answer questions you might have about HIV and can often provide you with referrals to local resources.

 

Going to a Local Testing Site

When you test for HIV, you may decide you don't want to see your regular doctor. Or, you may prefer to have a trained testing counselor on hand for you. In this case, you could look in the phone book to find the number of your local Department of Public Health. They can direct you to a local anonymous or confidential testing site or public health clinic that provides HIV screening.

These sites usually provide counseling free of charge along with the screening. You could then talk one-on-one with the counselor who can answer the questions you might have. They usually can refer you to HIV prevention resources in your area and provide you with emotional support. And, if you do test positive, they can help you cope with the news and direct you to local resources for more support. Some sites use standard blood draws or saliva swabs, where results are often available in a week or two after being sent to a lab and processed. Some sites have saliva-based rapid tests available (called OraQuick). These test results may be read in about 20 minutes.

 

Using an In-Home Kit

Perhaps you feel uneasy talking to someone face-to-face or fear going to an HIV testing site. In this case, you can test by using an in-home collection kit. The Home Access kit can be bought online (www.homeaccess.com) and at many drug stores, but it's not available in every state.

The kit includes a booklet that discusses and answers some questions about HIV screening. It also contains a needle, a small blotter pad and a postage-paid envelope. You will also find a unique ID code that you must keep in order to get your results.

To use the kit, prick your finger with the needle and put a few drops of blood on the blotter pad, as directed. Mail the blotter pad in the postage-paid envelope. The booklet gives you a toll-free phone number to call for your results.

When you call, an automated machine will ask you to enter your ID code. After you do, you will be passed to a counselor who will explain your test results and answer your questions. Over the phone, the counselor can give you a list of referrals for HIV prevention or other services in your area. If you want, they often can link you directly by phone to them.

The kit costs in the $45-60 range (depending on how quickly you request your results). But before you choose to test this way, consider how you feel about being counseled over the phone, how you feel about getting information about your HIV status over the phone, and whether you may benefit more from face-to-face counseling.

Several in-home HIV test kits are advertised on the internet. Only one is approved by the FDA. That is the Home Access Express HIV-1 Test System, made by Home Access Health Corporation. Other tests are not proven reliable and should be avoided. The FDA offers the warning below to consumers about other HIV testing options.

 

The advertisers of the unapproved HIV home test kits claim that the presence of a visual indicator, such as a red dot, within 5-15 minutes of taking the test shows a positive result for HIV infection. These unapproved test kits use a simple finger prick process for home blood collection or a special sponge device for saliva collection. The blood or saliva sample is then added to a plastic testing device containing a special type of paper. A developing solution is added to determine if the sample is positive for HIV. The samples are not sent to a laboratory for professional analysis. Although this approach may seem faster and simpler, it may provide a less accurate result than can be achieved using an approved test, which is analyzed under more controlled conditions than is possible in the home.
Why Not Use More Sensitive Tests?
Other types of HIV tests are available, called HIV RNA tests. Rather than looking for antibodies, these tests look for the actual virus. Several tests are available, including Amplicor, bDNA and NASBA. These are routinely used to monitor people with HIV infection, find out their risk of disease progression and monitor the effect of anti-HIV therapy.

These tests are not routinely used to check for HIV infection. First, they cost a lot more than antibody tests. Second, a number of problems occur when using them to screen for the presence of HIV. The major problem is that they have a significant false positive rate. That means the test sometimes suggests that someone is infected when in fact they are not. Using these tests to screen for HIV has caused people emotional unrest. As well, antibody tests are more than 99.9% accurate.

How do HIV tests work?
HIV tests the antibody the  virus elicits when it enters the body.  The first test called the elisa test can be positive soon after insult.  There are now many immediate tests available forHIV such as oral saliva test, sexual secretion tests.  The definitive is more complicated and takes more time to develop.
HOW DOES HIV SPREAD DURING SEX?
To spread HIV during sex, HIV infection in blood or sexual fluids must be transmitted to someone. Sexual fluids come from a man's penis or from a woman's vagina, before, during, or after orgasm. HIV can be transmitted when infected fluid gets into someone's body. You can't spread HIV if there is no HIV infection. If you and your partners are not infected with HIV, there is no risk. An "undetectable viral load does NOT mean "no HIV infection." If there is no contact with blood or sexual fluids, there is no risk. HIV needs to get into the body for infection to occur.Safer sex guidelines are ways to reduce the risk of spreading HIV during sexual activity.
UNSAFE ACTIVITIES
Unsafe sex has a high risk of spreading HIV. The greatest risk is when blood or sexual fluid touches the soft, moist areas (mucous membrane) inside the rectum, vagina, mouth, nose, or at the tip of the penis. These can be damaged easily, which gives HIV a way to get into the body. Vaginal or rectal intercourse without protection is very unsafe. Sexual fluids enter the body, and wherever a man's penis is inserted, it can cause small tears that make HIV infection more likely. The receptive partner is more likely to be infected, although HIV might be able to enter the penis, especially if it has contact with HIV-infected blood or vaginal fluids for a long time or if it has any open sores.
SAFER ACTIVITIES
Most sexual activity carries some risk of spreading HIV. To reduce the risk, make it more difficult for blood or sexual fluid to get into your body.

Be awareof your body and your partner's. Cuts, sores, or bleeding gums increase the risk of spreading HIV. Rough physical activity also increases the risk. Even small injuries give HIV a way to get into the body.

Use a barrierto prevent contact with blood or sexual fluid. Remember that the body's natural barrier is the skin. If you don't have any cuts or sores, your skin will protect you against infection. However, in rare cases HIV can get into the body through healthy mucous membranes. The risk of infection is much higher if the membranes are damaged. The most common artificial barrier is a condom for men. You can also use a female condom to protect the vagina or rectum during intercourse.Lubricantscan increase sexual stimulation. They also reduce the chance that condoms or other barriers will break. Oil-based lubricants like Vaseline, oils, or creams can damage condoms and other latex barriers. Be sure to use water-based lubricants.

Oral sexhas some risk of transmitting HIV, especially if sexual fluids get in the mouth and if there are bleeding gums or sores in the mouth. Pieces of latex or plastic wrap over the vagina, or condoms over the penis, can be used as barriers during oral sex. Condoms without lubricants are best for oral sex. Most lubricants taste awful.
SAFE ACTIVITIES
Safe activities have no risk for spreading HIV. Abstinence (never having sex) is totally safe. Sex with just one partner is safe as long as neither one of you is infected and if neither one of you ever has sex or shares needles with anyone else. Fantasy, masturbation, or hand jobs (where you keep your fluids to yourself), sexy talk, and non-sexual massage are also safe. These activities avoid contact with blood or sexual fluids, so there is no risk of transmitting HIV.To be safe, assume that your sex partners are infected with HIV. You can’t tell if people are infected by how they look. They could be lying if they tell you they are not infected, especially if they want to have sex with you. Some people got HIV from their steady partners who were unfaithful "just once".Even people who got a negative test result might be infected. They might have been infected after they got tested, or they might have gotten the test too soon after they were exposed to HIV.
WHAT IF BOTH PEOPLE ARE ALREADY INFECTED?
Some people who are HIV-infected don't see the need to follow safer sex guidelines when they are sexual with other infected people. However, it still makes sense to "play safe". If you don't, you could be exposed to other sexually transmitted infections such as herpes or syphilis. If you already have HIV, these diseases can be more serious. Also, you might get "re-infected" with a different strain of HIV. This new version of HIV might not be controlled by the medications you are taking. It might also be resistant to other antiretroviral drugs. There is no way of knowing how risky it is for two HIV-positive people to have unsafe sex. Following the guidelines for safer sex will reduce the risk.
KNOW WHAT YOU'RE DOING
Using alcohol or drugs before or during sex greatly increases the chances that you will not follow safer sex guidelines. Be very careful if you have used any alcohol or drugs.
SET YOUR LIMITS
Decide how much risk you are willing to take. Know how much protection you want to use during different kinds of sexual activities. Before you have sex, 
  • think about safer sex
  • set your limits
  • get a supply of lubricant and condoms or other barriers, and be sure they are easy to find when you need them
  • talk to your partners so they know your limits.
Stick to your limits. Don't let alcohol or drugs or an attractive partner make you forget to protect yourself.
THE BOTTOM LINE
HIV infection can occur during sexual activity. Sex is safe only if there is no HIV, no blood or sexual fluids, or no way for HIV to get into the body. You can reduce the risk of infection if you avoid unsafe activities or if you use barriers like condoms. Decide on your limits and stick to them.
WHAT IS ANTIRETROVIRALTHERAPY?
ARV therapy means treating viral infections like HIV with drugs. The drugs do not kill the virus. However, they slow down the growth of the virus. When the virus is slowed down, so is HIV disease. Antiretroviral drugs are referred to as ARV. ARV therapy is referred to as ART.
WHAT ARE THE APPROVED ARV DRUGS?
Each type, or "class", of ARV drugs attacks HIV in a different way. The first class of anti-HIV drugs was the nucleoside reverse transcriptase inhibitors, also called "nukes". These drugs work by blocking Step 4, where the HIV genetic material is converted from RNA into DNA. Drugs in use in this class include: Another class of drugs blocks the same step of the life cycle, but in a different way. This class is the non-nucleoside reverse transcriptase inhibitors, or NNRTIs. Three NNRTIs have been approved: The third class of antiviral drugs block Step 10, where the raw material for new HIV virus is cut into specific pieces. Ten protease inhibitors are being used: A newer class of ARV drugs is fusion and attachment inhibitors. They prevent HIV from attaching to a cell by blocking Step 2 of the life cycle. Two drugs of this type have been approved: The newest type of ARV drug is the integrase inhibitor. They prevent HIV from combining its genetic code with the infected cell in Step 5 of the life cycle. The first drug of this type is:Raltegravir (RGV, Isentress)
How are the drugs used?
When HIV multiplies, most of the new copies are mutations: they are slightly different from the original virus. Some mutations keep multiplying even when you are taking an ARV drug. When this happens, the drug will stop working. This is called "developing resistance" to the drug.
If only one ARV drug is used, it is easy for the virus to develop resistance. But if two drugs are used, a successful mutant would have to "get around" both drugs at the same time. And if three drugs are used, especially if they attack HIV at different points in its life cycle, it's very hard for a mutation to show up that can resist all three drugs at the same time.
Using a triple-drug combination means that it takes much longer for resistance to develop. For this reason, using just one ARV drug (monotherapy) or two drugs, is not recommended.
WHAT IS IMMUNE RESTORATION?

Immune restoration means repairing the damage done to the immune system by HIV.

In a healthy immune system, there is a full range of CD4 cells (T-cells) that can fight different diseases. As HIV disease progresses, the number of CD4 cells drops. The first CD4 cells that HIV attacks are the ones that specifically fight HIV. Some types of CD4 cells can disappear, leaving gaps in the immune defenses. Immune restoration looks for ways to fill these gaps.

A healthy immune system can fight off

Opportunistic infections

(OIs). Because these infections develop when CD4 cell levels are low, many researchers think that CD4 cell counts are a good measure of immune function. They believe that increases in CD4 cell counts are a sign of immune restoration. There is some disagreement on this point.

HOW CAN THE IMMUNE SYSTEM BE RESTORED?

If antiretroviral therapy (ART) is started immediately after someone is infected with HIV, the immune system won't be damaged. Unfortunately, very few cases of HIV are identified that early. . As HIV infection continues, it can damage the immune system. Scientists are exploring several ways to repair this damage.

Improving the function of the thymus:

The thymus is a small organ located at the base of the throat. It takes white blood cells that come from the bone marrow and turns them into CD4 cells. It works the hardest when you're just 6 months old. Then it starts to shrink. Scientists used to think that the thymus stopped working by the age of 20. However, research shows that it keeps producing new CD4 cells much longer, maybe until age 50. Strong ART can allow the thymus to replace lost types of CD4 cells.

When scientists thought that the thymus stopped working at a young age, they studied transplanting a human or animal thymus into someone with HIV. They also tried to stimulate the thymus using thymic hormones. These methods might still be important for older people with HIV.

Restoring the number of immune cells:

As HIV disease progresses, the numbers of both CD4 (T4) and CD8 (T8) cells drop. Some researchers are trying to maintain or to increase the numbers of these cells.

One approach is called cell expansion. An individual's cells are multiplied outside the body, and then infused back into the body. A second approach is cell transfer. This involves giving a patient some immune cells from the patient's twin or an HIV-negative relative.

A third method uses cytokines. These are chemical messengers that support the immune response. The most work has been done on interleukin-2 (IL-2), which can lead to large increases in CD4 cells. .

Another approach is gene therapy. This involves changing the bone marrow cells that will travel to the thymus and become CD4 cells. Gene therapy tries to make the bone marrow cells immune to HIV infection.

Letting the immune system repair itself:

CD4 counts have increased for many people who have taken ART. Some scientists believe that the immune system might be able to heal and repair itself if it's not fighting off large numbers of HIV viruses. This approach seems more likely now that we know that the thymus keeps working until a person is almost 50 years old.

Most people take medications to prevent opportunistic infections when their CD4 cell counts go below 200. However, if these people take ART and their CD4 cell counts climb back over 200, it is safe in most cases to stop taking medications to prevent these infections. Be sure to talk to your health care provider before you stop taking any medication.

Stimulating HIV-specific immune response:

Researchers used a modified, killed HIV virus (Remune®) to stimulate the body's response to HIV. Remune is essentially the same as a vaccine, but it is given to people who are already HIV-infected. Years of research produced confusing and disappointing results. New approaches are being studied. One of these is a therapeutic vaccine called DermaVir. It is applied to the skin. DermaVir is being tested in a Phase I/II study.

A combination of HIV vaccines and interleukin-2 (IL-2) increased anti-HIV immune responses and led to immune control of HIV for up to a year in one study.

An "immune regulating hormone," Immunitin or HE2000, is being developed by Hollis-Eden Pharmaceuticals. It showed good results in a Phase II clinical trial.

 
ARE NEW CD4 CELLS AS GOOD AS OLD?

Most approaches to immune restoration try to increase the number of CD4 cells. This is based on the assumption that when CD4 cells increase, the immune system is stronger.
 

When people with HIV start taking ART, their CD4 cell counts usually go up. At first, the new CD4 cells are probably copies of existing types of CD4 cells. If some "types" of CD4 cells were lost, they won't come back right away. This could leave some gaps in the body's immune defenses.

However, if HIV stays under control for a few years, the thymus might make new CD4 cells that could fill in these gaps and restore the immune system. Some of these CD4 cells might help control HIV infection.

WHAT IS INTERLEUKIN-2?

Interleukin-2 (IL-2) is a protein made by the body. T-helper cells, a kind of white blood cell, produce IL-2 when they are stimulated by an infection. IL-2 makes infection-fighting cells multiply and mature. Patients who use IL-2 have large increases in their CD4 cell counts. IL-2 is called an immune modulator.
 

Interleukin-2 has been approved by the FDA for the treatment of some types of cancer, but has not yet been approved for the treatment of HIV disease. Health care providers can use it "off label" in patients with HIV.

Using gene splicing, the Chiron Corporation developed a way to manufacture IL-2. Their version is called Proleukin®.

WHO SHOULD TAKE INTERLEUKIN-2?

IL-2 stimulates the immune system and increases the number of CD4 cells. People who start with higher CD4 cell counts get larger CD4 cell increases.
 

Scientists do not agree on the value of the new CD4 cells generated by IL-2. That is, a CD4 cell count of 700 after IL-2 therapy might not be as good as a count of 700 before IL-2 therapy. The difference has to do with how many different types of CD4 cells you have.

Before HIV disease attacks your immune system, you have a full range of CD4 cells. There are actually millions of different types of CD4 cells, but an easier way to think about them is like the letters of the alphabet. Each letter is programmed to respond to one particular type of infection. With a healthy immune system, you have many copies of each letter. As your CD4 cell count goes down, you have fewer copies of each letter, and you might run out of some letters.

Let's say that you need to spell the word "zebra" in order to fight pneumonia. If you have lost all your copies of the letter "z", you can't spell zebra and you might develop pneumonia.

People who take IL-2 seem to get more copies of the "letters" (types of CD4 cells) that they still have, but don't get back the ones they have lost. They could still have gaps in their immune defenses.

Scientists are still studying the benefits of the CD4+ cells produced by IL-2 therapy. We do not know if these higher CD4 cell counts mean that people will stay healthier. Two major international studies are underway, studying thousands of patients. The results should be known within the next few years.

Researchers also used IL-2 to try to clear infected "resting" CD4 cells from the blood. These experiments were not successful. Studies are also examining the possible benefits of IL-2 during treatment interuptions.

HOW IS INTERLEUKIN-2 TAKEN?

IL-2 has been given as an intravenous infusion and as twice-daily subcutaneous (below the skin) injections. Early research showed that the largest increases in CD4 cells occurred when IL-2 was given every day for 5 days, once every 8 weeks. If the CD4 cell count climbs enough after the first few cycles, future cycles can occur less frequently.

The best dosage of IL-2 has not been determined. The dosage is stated as "millions of international units", or MIU. Some patients taking IL-2 have been followed for six years or more. After initially using IL-2 every 2 months, they increased the time between cycles to as much as 3 years. They still had significantly higher CD4 cell counts.

WHAT ARE THE SIDE EFFECTS & DRUG INTERACTIONS OF IL-2?

Without antiretroviral therapy (ART), IL-2 can increase HIV viral load up to six times its pre-treatment level. These increases disappear within one month. Combination antiretroviral therapy (ART) controls these "spikes" in viral load. You should not use IL-2 unless you are taking antiretroviral drugs (ARVs).
 

When IL-2 is given by intravenous infusion, the most common side effect is called capillary leak syndrome. This causes weight gain, swelling, low blood pressure, and other problems.

At lower doses, people taking IL-2 get flu-like symptoms, including fever, chills and muscle aches. Because IL-2 stimulates the immune system, it can make some immune disorders get worse, including arthritis, psoriasis, and diabetes. It can also reduce the number neutrophils, a particular type of infection-fighting cell, and can cause low levels of thyroid.

When IL-2 is given by subcutaneous injection, the side effects are usually milder than with intravenous infusions. There is the added side effect of irritation where the injection is given. Side effects show up from 2 to 6 hours after injection of IL-2, and disappear quickly after the end of each cycle.

IL-2 can cause mood changes including irritability, insomnia, confusion, or depression. These can continue for several days after IL-2 is stopped.

As far as drug interactions are concerned, the body naturally produces IL-2. No serious interactions with ARVs have been noted. Also, there is no evidence that the body develops resistance to IL-2 when it is given in cycles.

WHAT IS IMMUNE RESTORATION SYNDROME?

Some people who start antiretroviral therapy (ART) get health problems. This happens even though their HIV comes under control. An infection that they previously had might return. In other cases, they develop a new disease. This is linked to improvements in the patients' immune systems. The problems usually occur in the first two months after starting HIV therapy. This condition is sometimes called Immune Restoration Inflammatory Syndrome or IRIS. It may occur in about 20% of the people starting ART

IS IRIS SERIOUS, AND WHAT IS THE TREATMENT FOR IT?

No one wants to develop inflammation or an infection. However, most cases of immune restoration syndrome go away with continued HIV treatment.

What's probably more important is in the name of the syndrome: immune restoration. It is a sign that the immune system is getting stronger. It also shows that the immune system is responding to specific germs. Before HIV treatment, there might have been no response to these germs because the immune system was too weakThere is no specific treatment for immune restoration syndrome. Continued HIV treatment strengthens the immune system. This normally takes care of any infections that emerge.


There is no specific treatment for immune restoration syndrome. Continued HIV treatment strengthens the immune system. This normally takes care of any infections that emerge

However, in some cases, doctors slowed down the recovery of the immune system. By gradually increasing its strength, they avoided some of the immune restoration responses. This has mostly been tried in people who had very low T-cell counts before they started HIV treatment.

The immune response can be slowed down by using a steroid drug like prednisone. This can ease the inflammation while the immune system gets stronger

WHAT PROBLEMS CAN OCCUR FROM IRIS?

Immune restoration syndrome has been linked with the following types of infections or inflammation:
 

Cytomegalovirus:

Hepatitis B and C:

Herpes Zoster (Shingles) and Herpes Simplex

Molluscum (a skin infection.)

Mycobacterium Avium Complex (MAC): This opportunistic infection is related to tuberculosis. It can flare up during immune recovery. MAC during immune recovery may show unusual symptoms.

Progressive multifocal leucoencephalopathy (PML): Immune recovery can cause a serious worsening of PML.

Swollen lymph nodes

Tuberculosis: