Diagnosis of HIV/AIDS - Knowledge (XXG)

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further increase of false positives in NYC DOHMH STD Clinics during the end of 2007 and beginning of 2008, their clinics opted to forgo further oral screenings, and instead reinstituted testing using finger-stick whole blood. Despite the increase in false positives in NYC DOHMH, the CDC still continues to support the use of noninvasive oral fluid specimens due to their popularity in health clinics and convenience of use. The director of the HIV control program for public health at Seattle King county, reported OraQuick failed to spot at least 8 percent of 133 people found to be infected with a comparable diagnostic test. Strategies implemented to determine quality control and false positive rates were implemented. It is to be understood that any reactive OraQuick test result is a preliminary positive result and will always require a confirmatory test, regardless of the mean of testing (venipuncture whole blood, fingerstick whole blood or oral mucosal transudate fluid). Several other testing sites who did not experience a spike in false positive rates continue to use OraSure's OraQuick HIV Anti-body Testing.

314:(CDC) announced an initiative for voluntary, routine testing of all Americans aged 13–64 during health care encounters. An estimated 25% of infected individuals were unaware of their status; if successful, this effort was expected to reduce new infections by 30% per year. The CDC recommends elimination of requirements for written consent or extensive pre-test counseling as barriers to widespread routine testing. In 2006, the National Association of Community Health Centers implemented a model for offering free, rapid HIV testing to all patients between the ages of 13 and 64 during routine primary medical and dental care visits. The program increased testing rates, with 66% of the 17,237 patients involved in the study agreeing to testing (56% were tested for the first time). In September 2010, New York became the first state to require that hospitals and primary care providers offer an HIV test to all patients between the ages of 13 and 64 years. An evaluation of the law's impact found that it increased testing significantly throughout the state. 458:, and ENV gene-product groups are present, the result is positive. The three-gene-product approach to western blot interpretation has not been adopted for public health or clinical practice. Tests in which less than the required number of viral bands are detected are reported as indeterminate: a person who has an indeterminate result should be retested, as later tests may be more conclusive. Almost all HIV-infected persons with indeterminate western blot results will develop a positive result when tested in one month; persistently indeterminate results over a period of six months suggests the results are not due to HIV infection. In a generally healthy low-risk population, indeterminate results on western blot occur on the order of 1 in 5,000 patients. However, for those individuals who have had high-risk exposures to individuals where HIV-2 is most prevalent, Western Africa, an inconclusive western blot test may prove infection with HIV-2. 682:

if the pool tests positive, each sample is retested individually. Although this results in a dramatic decrease in cost, the dilution of the virus in the pooled samples decreases the effective sensitivity of the test, lengthening the window period by four days (assuming a 20-fold dilution, ~20hr virus doubling time, detection limit 50 copies/ml, making limit of detection 1,000 copies/ml). Since 2001, donated blood in the United States has been screened with nucleic-acid-based tests, shortening the window period between infection and detectability of disease to a median of 17 days (95% CI, 13–28 Days, assumes pooling of samples). A different version of this test is intended for use in conjunction with clinical presentation and other laboratory markers of disease progress for the management of

573:...the use of repeatedly reactive enzyme immunoassay followed by confirmatory western blot or immunofluorescent assay remains the standard method for diagnosing HIV-1 infection. A large study of HIV testing in 752 U.S. laboratories reported a sensitivity of 99.7% and specificity of 98.5% for enzyme immunoassay, and studies in U.S. blood donors reported specificities of 99.8% and greater than 99.99%. With confirmatory Western blot, the chance of a false-positive identification in a low-prevalence setting is about 1 in 250 000 (95% CI, 1 in 173 000 to 1 in 379 000). 450:. Some commercially prepared Western blot test kits contain the HIV proteins already on a cellulose acetate strip. Once the proteins are well-separated, they are transferred to a membrane and the procedure continues similar to an ELISA: the person's diluted serum is applied to the membrane and antibodies in the serum may attach to some of the HIV proteins. Antibodies that do not attach are washed away, and enzyme-linked antibodies with the capability to attach to the person's antibodies determine to which HIV proteins the person has antibodies. 615:). The chance that a positive test accurately indicates an HIV infection increases as the prevalence or rate of HIV infection increases in the population. Conversely, the negative predictive value will decrease as the HIV prevalence rises. Thus a positive test in a high-risk population, such as people who frequently engage in unprotected anal intercourse with unknown partners, is more likely to correctly represent HIV infection than a positive test in a very low-risk population, such as unpaid blood donors. 490: 426: 804: 555:

initially blamed on the influenza vaccines used during that flu season, but further investigation traced the cross-reactivity to several relatively non-specific test kits. A false positive result does not indicate a condition of significant risk to health. When the ELISA test is combined with Western Blot, the rate of false positives is extremely low, and diagnostic accuracy is very high (see below).

42: 863:. While AIDS denialists focus on individual components of HIV testing, the combination of ELISA and western blot used for the diagnosis of HIV is remarkably accurate, with very low false-positive and -negative rates as described above. The views of AIDS denialists are based on highly selective analysis of mostly outdated scientific papers; there is broad 478: 597:

of these tests is extremely high, meaning that a negative test result will be correct more than 9,997 times in 10,000 (99.97% of the time). The very high negative predictive value of these tests is why the CDC recommends that a negative test result be considered conclusive evidence that an individual

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As a result of an increase in false positive rates with rapid oral HIV testing in 2005, New York City's Department of Health and Mental Hygiene added the option of testing finger-stick whole blood after any reactive result, before using a western blot test to confirm the positive result. Following a

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In general, the lower the number of T cells the lower the immune system's function will be. Normal CD4 counts are between 500 and 1500 CD4+ T cells/microliter, and the counts may fluctuate in healthy people, depending on recent infection status, nutrition, exercise, and other factors. Women tend to

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occur. This use of a CD4 count as an AIDS criterion was introduced in 1992; the value of 200 was chosen because it corresponded with a greatly increased likelihood of opportunistic infection. Lower CD4 counts in people with AIDS are indicators that prophylaxis against certain types of opportunistic

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The South African government announced a plan to start screening for HIV in secondary schools by March 2011. This plan was cancelled due to concerns it would invade pupils' privacy, schools typically don't have the facilities to securely store such information, and schools generally do not have the

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Nucleic-acid-based tests amplify and detect one or more of several target sequences located in specific HIV genes, such as HIV-I GAG, HIV-II GAG, HIV-env, or the HIV-pol. Since these tests are relatively expensive, the blood is screened by first pooling some 8–24 samples and testing these together;

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HIV antibody tests are highly sensitive, meaning they react preferentially with HIV antibodies, but not all positive or inconclusive HIV ELISA tests mean the person is infected by HIV. Risk history, and clinical judgement should be included in the assessment, and a confirmation test (western blot)

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Considerable controversy exists over the ethical obligations of health care providers to inform the sexual partners of individuals infected with HIV that they are at risk of contracting the virus. Some legal jurisdictions permit such disclosure, while others do not. More state funded testing sites

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Low CD4 T-cell counts are associated with a variety of conditions, including many viral infections, bacterial infections, parasitic infections, primary immunodeficiency, coccidioidomycosis, burns, trauma, intravenous injections of foreign proteins, malnutrition, over-exercising, pregnancy, normal

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to concentrate the virus, which is then opened to release its RNA. Special oligonucleotides that bind to viral RNA and to certain oligonucleotides bound to the wall of the vessel are added. In this way, viral RNA is fastened to the wall. Then new oligonucleotides that bind at several locations to

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In blood donation screening, this test is no longer used routinely in the US or the EU since the objective was to reduce the risk of false negatives in the window period. Nucleic acid testing (NAT) is more effective for this purpose, and p24 antigen testing is no longer indicated if a NAT test is

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Rare false positive results due to factors unrelated to HIV exposure are found more often with the ELISA test than with the western blot. False positives may be associated with medical conditions such as recent acute illnesses and allergies. A rash of false positive tests in the fall of 1991 was

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In developing countries, home-based HIV testing and counseling (HBHTC) is an emerging approach for addressing confidentiality issues. HBHTC allows individuals, couples, and families to learn their HIV status in the convenience and privacy of their home environment. Rapid HIV tests are most often

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There have been a number of cases of fraudulent tests being sold via mail order or the Internet to the general public. In 1997, a California man was indicted on mail fraud and wire charges for selling supposed home test kits. In 2004, the US Federal Trade Commission asked Federal Express and US

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If no antibodies to HIV are detected, this does not mean the person has not been infected with HIV. It may take several months after HIV infection for the antibody response to reach detectable levels, during which time rapid testing for antibodies to HIV will not be indicative of true infection

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A CD4 count does not check for the presence of HIV. It is used to monitor immune system function in HIV-positive people. Declining CD4 T-cell counts are considered to be a marker of progression of HIV infection. A normal CD4 count can range from 500 cells/mm3 to 1000 cells/mm3. In HIV-positive

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In general diagnostics, p24 antigen tests are used for early detection of HIV, as p24 antigen rises soon after infection relative to antibodies, and the test is often used in combination with an antibody test to effectively cover a longer portion of the window period. It is less useful as a

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this RNA are added, and other oligonucleotides that bind at several locations to those oligonucleotides. This is done to amplify the signal. Finally, oligonucleotides that bind to the last set of oligonucleotides and that are bound to an enzyme are added; the enzyme action causes a

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Customs to confiscate shipments of the Discreet home HIV test kits, produced by Gregory Stephen Wong of Vancouver, Canada. In February 2005, the US FDA issued a warning against using the rapid HIV test kits and other home use kits marketed by Globus Media of Montreal, Canada.

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and negative predictive value of all tests, including HIV tests, take into account the prior probability of having a disease along with the accuracy of the testing method to determine a new degree of belief that an individual has or does not have a disease (also known as the

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This test is also used occasionally to estimate immune system function for people whose CD4 T cells are impaired for reasons other than HIV infection, which include several blood diseases, several genetic disorders, and the side effects of many chemotherapy drugs.

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MacDonald K, Jackson J, Bowman R, Polesky H, Rhame F, Balfour H, Osterholm M (1989). "Performance characteristics of serologic tests for human immunodeficiency virus type 1 (HIV-1) antibody among Minnesota blood donors. Public health and clinical implications".

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Testing that has only a number attached to the specimen that will be delivered for testing. Items that are confirmed positive will not have the HIV infected individual's name attached to the specimen. Sites that offer this service advertise this testing option.

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specific to the p24 protein are mixed with the person's blood. Any p24 protein in the person's blood will stick to the monoclonal antibody and an enzyme-linked antibody to the monoclonal antibodies to p24 causes a color change if p24 was present in the sample.

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is diluted 400-fold and applied to a plate to which HIV antigens have been attached. If antibodies to HIV are present in the serum, they may bind to these HIV antigens. The plate is then washed to remove all other components of the serum. A specially prepared

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for the enzyme is applied, and catalysis by the enzyme leads to a change in color or fluorescence. ELISA results are reported as a number; the most controversial aspect of this test is determining the "cut-off" point between a positive and negative result.

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standalone test, as it has low sensitivity and only works during the early time period after infection. The presence of p24 antigen diminishes as the body increases production of antibodies to the p24 protein, making p24 more difficult to detect later.

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capacity to provide counseling for HIV-positive pupils. In South Africa, anyone over the age of 12 may request an HIV test without parental knowledge or consent. Some 80,000 pupils in three provinces were tested under this programme before it ended.

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ELISA testing alone cannot be used to diagnose HIV, even if the test suggests a high probability that antibody to HIV-1 is present. In the United States, such ELISA results are not reported as "positive" unless confirmed by a western blot.

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Farzadegan H, Vlahov D, Solomon L, Muñoz A, Astemborski J, Taylor E, Burnley A, Nelson K (1993). "Detection of human immunodeficiency virus type 1 infection by polymerase chain reaction in a cohort of seronegative intravenous drug users".

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A combination, or 4th generation assay, is designed to detect both the p24 antigen and HIV antibodies in a single test. Combination tests can detect HIV as early as 2–6 weeks after infection, and are recommended in laboratory testing.

214:) and more expeditious nucleic acid testing (NAT). These diagnostic tests are combined with careful donor selection. As of 2001, the risk of transfusion-acquired HIV in the US was approximately one in 2.5 million for each transfusion. 445:

within are placed into a slab of gel, to which an electric current is applied. Different proteins will move with different speeds in this field, depending on their size, while their electrical charge is leveled by a surfactant called

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There are no universal criteria for interpreting the western blot test: The number of viral bands that must be present may vary. If no viral bands are detected, the result is negative. If at least one viral band for each of the GAG,

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is implemented. Most people develop detectable antibodies approximately 18 to 30 days after exposure, although some do seroconvert later. The vast majority of people (99%) have detectable antibodies by two months after HIV exposure.

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are now using confidential forms of testing. This allows for monitoring of infected individuals easily, compared to anonymous testing that has a number attached to the positive test results. Controversy exists over privacy issues.

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C B Hare, B L Pappalardo, M P Busch, B Phelps, S S Alexander, C Ramstead, J A Levy, F M Hecht (2004). "Negative HIV antibody test results among individuals treated with antiretroviral therapy (ART) during acute/early infection".

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Mas A, Soriano V, Gutiérrez M, Fumanal F, Alonso A, González-Lahoz J (1997). "Reliability of a new recombinant immunoblot assay (RIBA HIV-1/HIV-2 SIA) as a supplemental (confirmatory) test for HIV-1 and HIV-2 infections".

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Of course, the actual numbers vary depending on the testing population. This is because interpreting of the results of any medical test (assuming no test is 100% accurate) depends upon the initial degree of belief, or the

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used, so results are available for the client between 15 and 30 minutes. Furthermore, when an HIV-positive result is communicated, the HTC provider can offer appropriate linkages for prevention, care, and treatment.

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is an antibody detection test. However, unlike the ELISA method, the viral proteins are separated first and immobilized. In subsequent steps, the binding of serum antibodies to specific HIV proteins is visualized.

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Burke D, Brundage J, Redfield R, Damato J, Schable C, Putman P, Visintine R, Kim H (1988). "Measurement of the false positive rate in a screening program for human immunodeficiency virus infections".

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Modern HIV testing is highly accurate. The evidence regarding the risks and benefits of HIV screening was reviewed in July 2005 by the U.S. Preventive Services Task Force. The authors concluded that:

1768:"Simultaneous detection of multiplex-amplified human immunodeficiency virus type 1 RNA, hepatitis C virus RNA, and hepatitis B virus DNA using a flow cytometer microsphere-based hybridization assay" 2682: 847:(a fringe group whose members believe that HIV either does not exist or is harmless). The accuracy of serologic testing has been verified by isolation and culture of HIV and by detection of HIV 2646: 1048: 721:

bound to the vessel wall, and are then made visible with a probe bound to an enzyme. The amount of virus in the sample can be quantified with sufficient accuracy to detect threefold changes.

634: 585:. Confirming the test result (i.e., by repeating the test, if this option is available) could reduce the ultimate likelihood of a false positive to about 1 result in 250,000 tests given. The 210:

In the US, the Food and Drug Administration requires that all donated blood be screened for several infectious diseases, including HIV-1 and HIV-2, using a combination of antibody testing (

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that an individual has, or does not have a disease. Generally the prior probability is estimated using the prevalence of a disease within a population or at a given testing location. The

2365: 356:(PEP). Those patients must take ELISA tests at various intervals after the usual 28-day course of treatment, sometimes extending outside of the conservative window period of 6 months. 2737: 117:

The eclipse period is a variable period starting from HIV exposure in which no existing test can detect HIV. The median duration of the eclipse period in one study was 11.5 days. The

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during the window period can delay the formation of antibodies and extend the window period beyond 12 months. This was not the case with patients that underwent treatment with

3328: 2382: 166:, or the presence of antibodies directed to other infectious agents that may be antigenically similar to HIV can produce false positive results. Autoimmune diseases, such as 581:

rate given here for the inexpensive enzyme immunoassay screening tests indicates that, in 1,000 HIV test results of healthy individuals, about 15 of these results will be a

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This image of Randall L. Tobias is used in a Korean news article suggesting that foreign English teachers residing in Korea are at risk for AIDS. Accessed 16 February 2010.

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or computer without additional support or battery power, and takes some fifteen minutes to analyse a drop of blood. The units cost approximately $ 34 each to manufacture.

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to aid in the diagnosis of HIV infection. These tests should be used in conjunction with the clinical status, history, and risk factors of the person being tested. The

3366: 2843: 384:" – an antibody that binds to human antibodies – is then applied to the plate, followed by another wash. This secondary antibody is chemically linked in advance to an 3415: 2316: 2216: 2203: 2717: 1160: 1138: 2589: 2408: 2358: 2306: 1919: 2702: 121:

is the time between HIV exposure and when an antibody or antigen test can detect HIV. The median window period for antibody/antigen testing is 18 days.

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During the window period, an infected person can transmit HIV to others although their HIV infection may not be detectable with an antibody test.

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procedure determines the size of the antigens in the test kit binding to the antibodies. The combination of these two methods is highly accurate

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Tests selected to screen donor blood and tissue must provide a high degree of confidence that HIV will be detected if present (that is, a high

2677: 2175: 1956: 3359: 3108: 1470:"Evaluation of screened blood donations for human immunodeficiency virus type 1 infection by culture and DNA amplification of pooled cells" 322:

HIV antibody tests are specifically designed for routine diagnostic testing of adults; these tests are inexpensive and extremely accurate.

2796: 2029: 629: 2004: 1849:"Dynamics of HIV viremia and antibody seroconversion in plasma donors: Implications for diagnosis and staging of primary HIV infection" 3233: 2473: 523:

Although these tests have high specificity, false positives do occur. Any positive test result should be confirmed by a lab using the

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Fiebig EW, Wright DJ, Rawal BD, Garrett PE, Schumacher RT, Peddada L, Heldebrant C, Smith R, Conrad A, Kleinman SH, Busch MP (2003).

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Van de Perre P, Simonon A, Msellati P, Hitimana D, Vaira D, Bazubagira A, Van Goethem C, Stevens A, Karita E, Sondag-Thull D (1991).

1139:"Community Health Centers Integrate Rapid HIV Screening into Routine Primary Care, Leading to Significant Increases in Testing Rates" 340:, hence an interval of three weeks to six months between the time of HIV exposure and the production of measurable antibodies to HIV 2656: 2546: 1934: 1680: 1352:"False-positive HIV-1 test results in a low-risk screening setting of voluntary blood donation. Retrovirus Epidemiology Donor Study" 365: 2133: 1815: 1511:"Postnatal transmission of human immunodeficiency virus type 1 from mother to infant. A prospective cohort study in Kigali, Rwanda" 250:

The UNAIDS/WHO policy statement on HIV Testing states that conditions under which people undergo HIV testing must be anchored in a

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Simonsen L, Buffington J (June 1995). "Multiple false reactions in viral antibody screening assays after influenza vaccination".

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Western blot test results. The first two strips are a negative and a positive control, respectively. The others are actual tests.

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of Rapid Antibody Tests in low-risk populations has not been evaluated. These tests should be used in appropriate multi-test

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ELISA antibody test. This is why a confirmatory western blot is always used before reporting a "positive" HIV test result.

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ELISA antibody test is in fact infected with HIV. Sometimes, retesting the donor in several months will produce a

3504: 3247: 3215: 3203: 3156: 2732: 2231: 1909: 852: 706: 622:, reporting false-positive rates of 0.0004 to 0.0007 and false-negative rates of 0.003 in the general population. 607: 594: 509: 353: 204: 3088: 2938: 2811: 2499: 2458: 389: 207:

estimated that, as of 2000, inadequate blood screening had resulted in 1 million new HIV infections worldwide.

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All diagnostic tests have limitations, and sometimes their use may produce erroneous or questionable results.

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infected with HIV. It is therefore not possible to conclude that blood rejected for transfusion because of a

388:. Thus the plate will contain enzyme in proportion to the amount of secondary antibody bound to the plate. A 3306: 3178: 3053: 2971: 2873: 2438: 2433: 1161:"New York State Legislation Leads to More HIV Testing and Linking of HIV-Positive Patients to Followup Care" 769: 170:, have also rarely caused false positive results. Most false negative results are due to the window period. 3499: 1706: 593:

result. However, based upon the HIV prevalence rates at most testing centers within the United States, the

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Bartlett, JG. Serologic tests for the diagnosis of HIV infection, in UpToDate. Accessed 5 October 2006.

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rating, likewise, indicates that, in 1,000 test results of HIV infected people, 3 will actually be a

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The ELISA antibody tests were developed to provide a high level of confidence that donated blood was

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Busch M, Eble B, Khayam-Bashi H, Heilbron D, Murphy E, Kwok S, Sninsky J, Perkins H, Vyas G (1991).

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should be administered. An individual with an inconclusive test should be re-tested at a later date.

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JM Appel (June 2006). "Must My Doctor Tell My Partner? Rethinking Confidentiality in the HIV Era".

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combining two tests for HIV antibodies. If antibodies are detected by an initial test based on the

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Tests used for the diagnosis of HIV infection in a particular person require a high degree of both

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unique to the virus's genome. After PCR amplification is complete, the resulting DNA products are

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people, AIDS is officially diagnosed when the count drops below 200 cells/μL or when certain

3547: 3537: 3516: 3280: 3058: 3038: 3033: 2963: 2898: 2641: 1860: 1787: 1779: 1622: 1576: 1522: 1481: 1439: 1400: 1363: 1327: 1322: 1310: 1283: 1248: 1083: 920: 501: 307: 272: 3585: 3420: 3410: 2791: 2531: 2301: 1816:"Instruction Manual – MPCR Kit for Human Immunodeficiency Virus (HIV) Type I/II, MaximBio" 1008: 996: 844: 718: 462: 372:(EIA), was the first screening test commonly employed for HIV. It has a high sensitivity. 2154: 1684: 1350:

Kleinman S, Busch M, Hall L, Thomson R, Glynn S, Gallahan D, Ownby H, Williams A (1998).

1311:"Screening for HIV: a review of the evidence for the U.S. Preventive Services Task Force" 907:

Delaney KP, Hanson DL, Masciotra S, Ethridge SF, Wesolowski L, Owen SM (1 January 2017).

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status. For most people, HIV antibodies reach a detectable level after two to six weeks.

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Armstrong WS, Taege AJ (April 2007). "HIV screening for all: the new standard of care".

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Please help update this article to reflect recent events or newly available information.

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Complete List of Donor Screening Assays for Infectious Agents and HIV Diagnostic Assays

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Many studies have confirmed the accuracy of current methods of HIV testing in the

2005:"Seattle Department Finds OraSure HIV Test to Be Less Accurate Than Label Claims" 1895: 3669: 3592: 2661: 2562: 2353: 1527: 1510: 1486: 1469: 1443: 1404: 376: 72: 2085: 1626: 41: 3428: 3375: 2621: 2463: 2291: 737: 414: 200: 152:: The test incorrectly indicates that HIV is present in a non-infected person. 141:: The percentage of the results that will be negative when HIV is not present. 84: 2227: 1549:

Update: serologic testing for HIV-1 antibody – United States, 1988 and 1989.

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is to screen all patients for HIV in all health care settings. In 2006, the

231: 1874: 1801: 1336: 1260: 1095: 1034: 2059: 1634: 1590: 1536: 1495: 1451: 1412: 1377: 1295: 1087: 158:: The test incorrectly indicates that HIV is absent in an infected person. 3674: 3664: 3395: 2727: 2626: 2323: 2271: 924: 410: 188: 135:: The percentage of the results that will be positive when HIV is present 68: 50: 1581: 1564: 49:, former U.S. Global AIDS Coordinator, being publicly tested for HIV in 3659: 3623: 3524: 2651: 989: 442: 192: 88: 1982:"False-Positive Oral Fluid Rapid HIV Tests – New York City, 2005–2008" 3560: 2767: 1049:"Getting in the Door: Home-Based HIV Testing and Counseling in Kenya" 406: 385: 76: 477: 1766:

Defoort JP, Martin M, Casano B, Prato S, Camilla C, Fert V (2000).

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In the Quantiplex bDNA or branched DNA test, plasma is placed in a

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Scand J Infect Dis. 1992;24(4):419-21. Accessed 23 September 2008.

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Specifically, cells that may be HIV-infected are opened and the

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is not an HIV test, but rather a procedure where the number of

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designed for statistical validation of rapid HIV test results.

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European and Developing Countries Clinical Trials Partnership

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Chou R, Huffman LH, Fu R, Smits AK, Korthuis PT (July 2005).

999:. From the Puget Sound Blood Center. Accessed 5 October 2006. 777:

daily variation, psychological stress, and social isolation.

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The HIV proteins used in western blotting can be produced by

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Performance of medical tests is often described in terms of:

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Fact sheets from the National Aids Trust ("NAT") in the UK:

2056:"Testing for HIV – Why and How | Free Testing Site HAF" 651:

of HIV (also known as CA), the capsid protein of the virus.

2111: 1163:. Agency for Healthcare Research and Quality. 10 April 2013 1141:. Agency for Healthcare Research and Quality. 5 April 2013 2366:

WHO disease staging system for HIV infection and disease

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Accompanied by counseling (for those who test positive);

2030:"Overview of False-Positive Oral Fluid Rapid HIV Tests" 3334:

List of HIV/AIDS cases and deaths registered by region

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Henry J. Kaiser Family Foundation (5 September 2008).

2176:"Defective HIV Test Kit Marketer Settles FTC Charges" 2084:. Harlem United Community AIDS Center. Archived from 3683: 3645: 3601: 3473: 3386: 3329:

List of countries by HIV/AIDS adult prevalence rate

3294: 3246: 3214: 3155: 3127: 2962: 2819: 2810: 2718:

President's Emergency Plan for AIDS Relief (PEPFAR)

2703:

Joint United Nations Programme on HIV/AIDS (UNAIDS)

2670: 2555: 2487: 2391: 2279: 1683:. Eurosurveillance. 1 February 2005. Archived from 1565:"Increased sensitivity of HIV-1 antibody detection" 990:

Adverse reactions associated with blood transfusion

34: 230:. In the United States, this is achieved using an 1957:"Lymphocyte surface marker analysis - Immunology" 647:The p24 antigen test detects the presence of the 53:in an effort to reduce the stigma of being tested 1009:UNAIDS/WHO policy statement on HIV Testing (PDF) 125:(NAT) further reduces this period to 11.5 days. 3416:Fluorescent treponemal antibody absorption test 2317:National Addiction and HIV Data Archive Program 571: 3360: 2252: 8: 1463: 1461: 1424: 1422: 2409:Diffuse infiltrative lymphocytosis syndrome 2058:. Freehivtesting.hafnyc.org. Archived from 179:Screening donor blood and cellular products 3367: 3353: 3345: 3161: 2816: 2642:People With AIDS Self-Empowerment Movement 2259: 2245: 2237: 1563:Urnovitz H, Sturge J, Gottfried T (1997). 1115: 1113: 40: 3401:Venereal Disease Research Laboratory test 1864: 1791: 1580: 1526: 1485: 1367: 1326: 709:(PCR) process is then applied, using two 1922:from the original on 21 September 2013. 1707:"HIV Tests For Screening and Diagnosis" 1328:10.7326/0003-4819-143-1-200507050-00010 884: 109:AIDS is diagnosed separately from HIV. 63:are used to detect the presence of the 2108:"The scientific evidence for HIV/AIDS" 31: 2678:Discredited HIV/AIDS origins theories 785:have somewhat lower counts than men. 238:method, then a second test using the 7: 1185:The XV International AIDS Conference 902: 900: 493:Blood being taken for HIV rapid test 481:A woman demonstrates the use of the 2797:The Freddie Mercury Tribute Concert 2155:"The Controversy over HIV and AIDS" 2134:"The Evidence That HIV Causes AIDS" 701:(RT) to convert the viral RNA into 306:In the United States, one emerging 2213:General information on HIV testing 1288:10.1093/oxfordjournals.aje.a117374 1187:. pp. Abstract no. MoPeB3107. 843:HIV tests have been criticized by 668:Antigen/antibody combination tests 254:approach that pays due respect to 25: 2383:Countries by AIDS prevalence rate 2228:Bulk procurement of HIV test kits 1198:Mariella Moon (6 February 2015). 1023:Medicine and Health, Rhode Island 949:. US Food and Drug Administration 773:infections should be instituted. 752:Other tests used in HIV treatment 504:immunoassays intended for use in 366:enzyme-linked immunosorbent assay 2844:Democratic Republic of the Congo 2404:AIDS-defining clinical condition 1896:FDA summary of branched DNA test 1866:10.1097/00002030-200309050-00005 1772:Journal of Clinical Microbiology 802: 693:is extracted from the patient's 105:AIDS-defining clinical condition 2110:. AIDSTruth.org. Archived from 1784:10.1128/JCM.38.3.1066-1071.2000 867:that HIV is the cause of AIDS. 409:capable of testing for HIV and 187:is required). A combination of 3717:Infectious disease blood tests 3553:Orthopoxvirus inclusion bodies 1740:. 27 June 2014. Archived from 677:Nucleic acid-based tests (NAT) 433:Like the ELISA procedure, the 302:Routine testing recommendation 1: 2713:Misconceptions about HIV/AIDS 2693:International AIDS Conference 2647:HIV/AIDS in the porn industry 2590:Discrimination against people 1253:10.1016/s0955-3886(96)00078-1 1051:. Aidstar-One. Archived from 855:, which are widely accepted " 375:In an ELISA test, a person's 67:(HIV), the virus that causes 2573:Catholic Church and HIV/AIDS 2454:HIV Drug Resistance Database 1712:Food and Drug Administration 1654:Food and Drug Administration 913:Clinical Infectious Diseases 764:in the blood is determined. 473:Rapid or point-of-care tests 467:recombinant immunoblot assay 405:have produced an ELISA test 168:systemic lupus erythematosus 65:human immunodeficiency virus 2874:Côte d'Ivoire (Ivory Coast) 2708:Media portrayal of HIV/AIDS 2637:List of HIV-positive people 1908:Smith D (2 February 2011). 1528:10.1056/NEJM199108293250901 1487:10.1056/NEJM199107043250101 1444:10.7326/0003-4819-110-8-617 1405:10.1056/NEJM198810133191501 531:Interpreting antibody tests 312:Centers for Disease Control 275:of the person being tested. 3738: 2774:Reports from the Holocaust 2698:International AIDS Society 2688:Elton John AIDS Foundation 1898:, accessed 5 October 2006. 1011:, accessed 5 October 2006. 735: 689:In the RT-PCR test, viral 630:Excessive citations inline 413:. It is compatible to any 218:Diagnosis of HIV infection 203:in Western countries. The 102: 3505:Heterophile antibody test 3324: 3164: 2733:Treatment Action Campaign 2449:Tuberculosis co-infection 2312:disease progression rates 2232:World Health Organization 1551:MMWR Morb Mortal Wkly Rep 995:27 September 2006 at the 811:This section needs to be 707:polymerase chain reaction 608:positive predictive value 595:negative predictive value 510:positive predictive value 354:post-exposure prophylaxis 205:World Health Organization 39: 2459:Innate resistance to HIV 2429:Neurocognitive disorders 2180:Federal Trade Commission 1627:10.1093/infdis/168.2.327 1369:10.1001/jama.280.12.1080 770:opportunistic infections 330:Antibody tests may give 83:. Such tests may detect 2780:AIDS–Holocaust metaphor 2763:Gay Men's Health Crisis 2439:Opportunistic infection 635:considered for deletion 565:Accuracy of HIV testing 162:Nonspecific reactions, 3647:Bloodstream infections 3616:Sabin–Feldman dye test 3531:Warthin–Finkeldey cell 2607:HIV-affected community 2547:HIV and homosexual men 2230:instructions from the 575: 494: 486: 465:in a technique called 430: 350:Antiretroviral therapy 164:hypergammaglobulinemia 2787:Silence=Death Project 2585:Criminal transmission 2505:Multiple sex partners 2082:"Prevention Division" 2032:. CDC. Archived from 1127:on 16 September 2008. 1088:10.3949/ccjm.74.4.297 736:Further information: 699:reverse transcriptase 653:Monoclonal antibodies 613:posterior probability 506:point-of-care testing 492: 480: 448:sodium lauryl sulfate 428: 35:Diagnosis of HIV/AIDS 3630:Diagnosis of malaria 3109:United Arab Emirates 2580:Circumcision and HIV 2537:City of Hope Patient 2297:structure and genome 971:. American Red Cross 865:scientific consensus 697:and is treated with 686:-infected patients. 123:Nucleic acid testing 3603:Protozoan infection 3463:Anti-streptolysin O 3406:rapid plasma reagin 3388:Bacterial infection 2657:AIDS Memorial Quilt 2469:HIV-positive people 2036:on 14 December 2012 1747:on 28 February 2017 1582:10.1038/nm1197-1258 1241:Transfusion Science 598:does not have HIV. 500:antibody tests are 403:Columbia University 271:Conducted with the 3691:C-reactive protein 3500:Epstein–Barr virus 3488:Branched DNA assay 3380:infectious disease 3234:Dominican Republic 2617:HIV/AIDS denialism 2542:Women and HIV/AIDS 2532:The London Patient 2399:Signs and symptoms 2307:CDC classification 2088:on 19 October 2012 2062:on 4 November 2013 1715:. 30 November 2016 1055:on 3 November 2013 925:10.1093/cid/ciw666 871:Fraudulent testing 738:Viral load testing 495: 487: 431: 382:secondary antibody 370:enzyme immunoassay 256:ethical principles 199:tests are used by 27:Immunological test 3704: 3703: 3449:HelicoCARE direct 3342: 3341: 3320: 3319: 3242: 3241: 2723:The SING Campaign 2612:HIV/AIDS activism 2600:Cost of treatment 2522:Timothy Ray Brown 2517:World AIDS Museum 2217:Types of HIV test 1859:(13): 1871–1879. 1687:on 28 August 2008 832: 831: 604:prior probability 401:Researchers from 293:Anonymous testing 58: 57: 47:Randall L. Tobias 16:(Redirected from 3729: 3635:Schüffner's dots 3548:B type inclusion 3538:Inclusion bodies 3517:NS1 antigen test 3369: 3362: 3355: 3346: 3312:Papua New Guinea 3162: 2817: 2261: 2254: 2247: 2238: 2192: 2191: 2189: 2187: 2172: 2166: 2165: 2163: 2161: 2151: 2145: 2144: 2142: 2140: 2130: 2124: 2123: 2121: 2119: 2104: 2098: 2097: 2095: 2093: 2078: 2072: 2071: 2069: 2067: 2052: 2046: 2045: 2043: 2041: 2026: 2020: 2019: 2017: 2015: 2000: 1994: 1993: 1991: 1989: 1978: 1972: 1971: 1969: 1967: 1953: 1947: 1946: 1944: 1942: 1930: 1924: 1923: 1905: 1899: 1893: 1887: 1886: 1868: 1844: 1838: 1837: 1835: 1833: 1827: 1821:. Archived from 1820: 1812: 1806: 1805: 1795: 1778:(3): 1066–1071. 1763: 1757: 1756: 1754: 1752: 1746: 1739: 1731: 1725: 1724: 1722: 1720: 1703: 1697: 1696: 1694: 1692: 1677: 1671: 1670: 1668: 1666: 1657:. Archived from 1645: 1639: 1638: 1609: 1603: 1602: 1584: 1560: 1554: 1547: 1541: 1540: 1530: 1506: 1500: 1499: 1489: 1465: 1456: 1455: 1426: 1417: 1416: 1388: 1382: 1381: 1371: 1347: 1341: 1340: 1330: 1315:Ann. Intern. Med 1306: 1300: 1299: 1271: 1265: 1264: 1235: 1229: 1226: 1220: 1217: 1211: 1210: 1208: 1206: 1195: 1189: 1188: 1179: 1173: 1172: 1170: 1168: 1157: 1151: 1150: 1148: 1146: 1135: 1129: 1128: 1123:. Archived from 1121:"CDC fact sheet" 1117: 1108: 1107: 1076:Cleve Clin J Med 1071: 1065: 1064: 1062: 1060: 1045: 1039: 1038: 1018: 1012: 1006: 1000: 987: 981: 980: 978: 976: 965: 959: 958: 956: 954: 943: 937: 936: 904: 895: 889: 827: 824: 818: 806: 805: 798: 758:CD4 T-cell count 719:oligonucleotides 685: 638: 308:standard of care 273:informed consent 44: 32: 21: 3737: 3736: 3732: 3731: 3730: 3728: 3727: 3726: 3707: 3706: 3705: 3700: 3679: 3641: 3597: 3586:Councilman body 3475:Viral infection 3469: 3435:Weil–Felix test 3421:Abelin reaction 3411:Wassermann test 3382: 3373: 3343: 3338: 3316: 3290: 3238: 3210: 3151: 3123: 3069:Myanmar (Burma) 2958: 2806: 2792:Day Without Art 2738:The Global Fund 2666: 2595:Economic impact 2551: 2483: 2387: 2339:pathophysiology 2275: 2265: 2200: 2195: 2185: 2183: 2174: 2173: 2169: 2159: 2157: 2153: 2152: 2148: 2138: 2136: 2132: 2131: 2127: 2117: 2115: 2114:on 2 March 2012 2106: 2105: 2101: 2091: 2089: 2080: 2079: 2075: 2065: 2063: 2054: 2053: 2049: 2039: 2037: 2028: 2027: 2023: 2013: 2011: 2002: 2001: 1997: 1987: 1985: 1980: 1979: 1975: 1965: 1963: 1955: 1954: 1950: 1940: 1938: 1932: 1931: 1927: 1907: 1906: 1902: 1894: 1890: 1846: 1845: 1841: 1831: 1829: 1828:on 14 July 2010 1825: 1818: 1814: 1813: 1809: 1765: 1764: 1760: 1750: 1748: 1744: 1737: 1733: 1732: 1728: 1718: 1716: 1705: 1704: 1700: 1690: 1688: 1679: 1678: 1674: 1664: 1662: 1647: 1646: 1642: 1611: 1610: 1606: 1562: 1561: 1557: 1548: 1544: 1508: 1507: 1503: 1467: 1466: 1459: 1428: 1427: 1420: 1390: 1389: 1385: 1349: 1348: 1344: 1308: 1307: 1303: 1282:(11): 1089–96. 1273: 1272: 1268: 1237: 1236: 1232: 1227: 1223: 1218: 1214: 1204: 1202: 1197: 1196: 1192: 1181: 1180: 1176: 1166: 1164: 1159: 1158: 1154: 1144: 1142: 1137: 1136: 1132: 1119: 1118: 1111: 1073: 1072: 1068: 1058: 1056: 1047: 1046: 1042: 1020: 1019: 1015: 1007: 1003: 997:Wayback Machine 988: 984: 974: 972: 969:"Blood Testing" 967: 966: 962: 952: 950: 945: 944: 940: 906: 905: 898: 890: 886: 882: 873: 845:AIDS denialists 841: 828: 822: 819: 816: 807: 803: 796: 791: 754: 745: 740: 683: 679: 670: 645: 623: 567: 533: 485:rapid HIV test. 475: 463:recombinant DNA 423: 399: 362: 328: 320: 304: 295: 282: 280:Confidentiality 248: 220: 181: 176: 115: 107: 101: 54: 28: 23: 22: 15: 12: 11: 5: 3735: 3733: 3725: 3724: 3719: 3709: 3708: 3702: 3701: 3699: 3698: 3693: 3687: 3685: 3681: 3680: 3678: 3677: 3672: 3667: 3662: 3657: 3651: 3649: 3643: 3642: 3640: 3639: 3638: 3637: 3632: 3620: 3619: 3618: 3607: 3605: 3599: 3598: 3596: 3595: 3590: 3589: 3588: 3576: 3571: 3570: 3569: 3557: 3556: 3555: 3550: 3545: 3535: 3534: 3533: 3521: 3520: 3519: 3509: 3508: 3507: 3497: 3496: 3495: 3490: 3479: 3477: 3471: 3470: 3468: 3467: 3466: 3465: 3453: 3452: 3451: 3439: 3438: 3437: 3425: 3424: 3423: 3418: 3413: 3408: 3403: 3392: 3390: 3384: 3383: 3374: 3372: 3371: 3364: 3357: 3349: 3340: 3339: 3337: 3336: 3331: 3325: 3322: 3321: 3318: 3317: 3315: 3314: 3309: 3304: 3298: 3296: 3292: 3291: 3289: 3288: 3283: 3278: 3273: 3268: 3263: 3258: 3252: 3250: 3244: 3243: 3240: 3239: 3237: 3236: 3231: 3226: 3220: 3218: 3212: 3211: 3209: 3208: 3207: 3206: 3196: 3191: 3186: 3181: 3176: 3171: 3165: 3159: 3153: 3152: 3150: 3149: 3144: 3139: 3137:United Kingdom 3133: 3131: 3125: 3124: 3122: 3121: 3116: 3111: 3106: 3101: 3096: 3091: 3086: 3081: 3076: 3071: 3066: 3061: 3056: 3051: 3046: 3041: 3036: 3031: 3026: 3021: 3016: 3015: 3014: 3004: 2999: 2994: 2989: 2984: 2979: 2974: 2968: 2966: 2960: 2959: 2957: 2956: 2951: 2946: 2941: 2936: 2931: 2926: 2921: 2916: 2911: 2906: 2901: 2896: 2891: 2886: 2881: 2876: 2871: 2866: 2861: 2856: 2851: 2846: 2841: 2836: 2831: 2825: 2823: 2814: 2808: 2807: 2805: 2804: 2799: 2794: 2789: 2784: 2783: 2782: 2777: 2770: 2765: 2755: 2750: 2748:YAA/Youthforce 2745: 2743:World AIDS Day 2740: 2735: 2730: 2725: 2720: 2715: 2710: 2705: 2700: 2695: 2690: 2685: 2680: 2674: 2672: 2668: 2667: 2665: 2664: 2659: 2654: 2649: 2644: 2639: 2634: 2629: 2624: 2619: 2614: 2609: 2604: 2603: 2602: 2592: 2587: 2582: 2577: 2576: 2575: 2565: 2559: 2557: 2553: 2552: 2550: 2549: 2544: 2539: 2534: 2529: 2527:Berlin Patient 2524: 2519: 2514: 2509: 2508: 2507: 2497: 2491: 2489: 2485: 2484: 2482: 2481: 2476: 2471: 2466: 2461: 2456: 2451: 2446: 2444:Superinfection 2441: 2436: 2431: 2426: 2424:Cardiomyopathy 2421: 2416: 2411: 2406: 2401: 2395: 2393: 2389: 2388: 2386: 2385: 2380: 2379: 2378: 2376:Teens / Adults 2373: 2363: 2362: 2361: 2356: 2351: 2346: 2341: 2336: 2331: 2321: 2320: 2319: 2314: 2309: 2304: 2299: 2294: 2283: 2281: 2277: 2276: 2266: 2264: 2263: 2256: 2249: 2241: 2235: 2234: 2225: 2224: 2223: 2207: 2199: 2198:External links 2196: 2194: 2193: 2167: 2146: 2125: 2099: 2073: 2047: 2021: 1995: 1973: 1961:www.ouh.nhs.uk 1948: 1937:. M.news24.com 1925: 1900: 1888: 1839: 1807: 1758: 1726: 1698: 1681:"View Article" 1672: 1661:on 11 May 2009 1640: 1604: 1555: 1542: 1501: 1457: 1432:Ann Intern Med 1418: 1383: 1362:(12): 1080–5. 1342: 1301: 1276:Am J Epidemiol 1266: 1230: 1221: 1212: 1190: 1174: 1152: 1130: 1109: 1082:(4): 297–301. 1066: 1040: 1013: 1001: 982: 960: 938: 896: 883: 881: 878: 872: 869: 857:gold standards 840: 839:AIDS denialism 837: 830: 829: 810: 808: 801: 795: 792: 790: 787: 753: 750: 744: 741: 731:color reaction 678: 675: 669: 666: 644: 641: 591:false negative 583:false positive 566: 563: 562: 561: 532: 529: 474: 471: 422: 419: 398: 395: 361: 358: 342:seroconversion 332:false negative 327: 324: 319: 318:Antibody tests 316: 303: 300: 294: 291: 281: 278: 277: 276: 269: 266: 247: 244: 219: 216: 180: 177: 175: 172: 160: 159: 156:False negative 153: 150:False positive 143: 142: 136: 114: 111: 103:Main article: 100: 99:AIDS diagnosis 97: 56: 55: 45: 37: 36: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 3734: 3723: 3720: 3718: 3715: 3714: 3712: 3697: 3696:Procalcitonin 3694: 3692: 3689: 3688: 3686: 3682: 3676: 3673: 3671: 3668: 3666: 3663: 3661: 3658: 3656: 3655:Blood culture 3653: 3652: 3650: 3648: 3644: 3636: 3633: 3631: 3628: 3627: 3626: 3625: 3621: 3617: 3614: 3613: 3612: 3611:toxoplasmosis 3609: 3608: 3606: 3604: 3600: 3594: 3591: 3587: 3584: 3583: 3582: 3581: 3577: 3575: 3574:Cowdry bodies 3572: 3568: 3565: 3564: 3563: 3562: 3558: 3554: 3551: 3549: 3546: 3544: 3543:Downie bodies 3541: 3540: 3539: 3536: 3532: 3529: 3528: 3527: 3526: 3522: 3518: 3515: 3514: 3513: 3510: 3506: 3503: 3502: 3501: 3498: 3494: 3491: 3489: 3486: 3485: 3484: 3481: 3480: 3478: 3476: 3472: 3464: 3461: 3460: 3459: 3458: 3457:Streptococcus 3454: 3450: 3447: 3446: 3445: 3444: 3440: 3436: 3433: 3432: 3431: 3430: 3426: 3422: 3419: 3417: 3414: 3412: 3409: 3407: 3404: 3402: 3399: 3398: 3397: 3394: 3393: 3391: 3389: 3385: 3381: 3377: 3370: 3365: 3363: 3358: 3356: 3351: 3350: 3347: 3335: 3332: 3330: 3327: 3326: 3323: 3313: 3310: 3308: 3305: 3303: 3300: 3299: 3297: 3293: 3287: 3284: 3282: 3279: 3277: 3274: 3272: 3269: 3267: 3264: 3262: 3259: 3257: 3254: 3253: 3251: 3249: 3248:South America 3245: 3235: 3232: 3230: 3227: 3225: 3222: 3221: 3219: 3217: 3213: 3205: 3204:New York City 3202: 3201: 3200: 3199:United States 3197: 3195: 3192: 3190: 3187: 3185: 3182: 3180: 3177: 3175: 3172: 3170: 3167: 3166: 3163: 3160: 3158: 3157:North America 3154: 3148: 3145: 3143: 3140: 3138: 3135: 3134: 3132: 3130: 3126: 3120: 3117: 3115: 3112: 3110: 3107: 3105: 3102: 3100: 3097: 3095: 3092: 3090: 3087: 3085: 3082: 3080: 3077: 3075: 3072: 3070: 3067: 3065: 3062: 3060: 3057: 3055: 3052: 3050: 3047: 3045: 3042: 3040: 3037: 3035: 3032: 3030: 3027: 3025: 3022: 3020: 3017: 3013: 3010: 3009: 3008: 3005: 3003: 3000: 2998: 2995: 2993: 2990: 2988: 2985: 2983: 2980: 2978: 2975: 2973: 2970: 2969: 2967: 2965: 2961: 2955: 2952: 2950: 2947: 2945: 2942: 2940: 2937: 2935: 2932: 2930: 2927: 2925: 2922: 2920: 2917: 2915: 2912: 2910: 2907: 2905: 2902: 2900: 2897: 2895: 2892: 2890: 2887: 2885: 2882: 2880: 2877: 2875: 2872: 2870: 2867: 2865: 2862: 2860: 2857: 2855: 2852: 2850: 2847: 2845: 2842: 2840: 2837: 2835: 2832: 2830: 2827: 2826: 2824: 2822: 2818: 2815: 2813: 2809: 2803: 2800: 2798: 2795: 2793: 2790: 2788: 2785: 2781: 2778: 2776: 2775: 2771: 2769: 2766: 2764: 2761: 2760: 2759: 2756: 2754: 2751: 2749: 2746: 2744: 2741: 2739: 2736: 2734: 2731: 2729: 2726: 2724: 2721: 2719: 2716: 2714: 2711: 2709: 2706: 2704: 2701: 2699: 2696: 2694: 2691: 2689: 2686: 2684: 2681: 2679: 2676: 2675: 2673: 2669: 2663: 2660: 2658: 2655: 2653: 2650: 2648: 2645: 2643: 2640: 2638: 2635: 2633: 2632:Sex education 2630: 2628: 2625: 2623: 2620: 2618: 2615: 2613: 2610: 2608: 2605: 2601: 2598: 2597: 2596: 2593: 2591: 2588: 2586: 2583: 2581: 2578: 2574: 2571: 2570: 2569: 2566: 2564: 2561: 2560: 2558: 2554: 2548: 2545: 2543: 2540: 2538: 2535: 2533: 2530: 2528: 2525: 2523: 2520: 2518: 2515: 2513: 2510: 2506: 2503: 2502: 2501: 2498: 2496: 2493: 2492: 2490: 2486: 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