HIV Doctor Near Me Screening and diagnostic testing for HIV infection HIV testing should be performed to diagnose HIV in patients with clinical signs and symptoms of acute or chronic infection as well as those with a possible exposure to HIV. HIV testing can also be incorporated into routine screening of healthy individuals, including pregnant women. Identifying patients infected with HIV is important because it allows the initiation of early antiretroviral therapy which reduces clinical events and mortality in patients with HIV along with appropriate preventive care and reduced HIV transmission to others through reductions in viral load secondary to therapy. The preferred testing algorithm uses a fourth generation antigen/antibody combination HIV-1/2 immunoassay plus a confirmatory HIV-1/HIV-2 antibody differentiation. The fourth generation immunoassay detects both HIV-1 and HIV-2 antibodies as well as HIV P24 antigen. If the fourth generation combination assay is negative, the person is considered HIV uninfected, and no further testing needs to be done. If the fourth generation combination assay is positive, then HIV-1/HIV-2 antibody differentiation immunoassay is performed. This test confirms the results of the combination assay and also provides information as to whether the patient is infected with HIV-1, HIV-2, or both viruses. A plasma HIV RNA level should be obtained to evaluate for acute infection if the fourth generation test is positive and the confirmatory HIV-1/HIV-2 antibody differentiation immunoassay is indeterminate or negative. Routine screening for HIV in some laboratories, is still done by using a two-tiered approach via an initial ELISA that only detects the presence of antibodies, followed by a confirmatory western blot if the initial ELISA is positive. This method can fail to diagnose individuals who are early in the course of their infection and can also misclassify HIV-2 as HIV-1. Rapid point of care antibody screening tests are sometimes performed for convenience and or cost. If the initial test is positive, a laboratory based combination antigen/antibody assay should be performed. Screening of an individual should be voluntary and undertaken only with the patient’s knowledge and understanding that HIV testing is planned. If a patient is diagnosed with HIV infection, it is important to obtain guidance from a specialist.