Testing for Acute HIV Infection

Types of HIV Tests

The most common test is an antibody test (EIA Enzyme Immunoassay, also known as an ELISA), which looks for antibodies that your body specifically makes in response to the HIV virus. These antibodies may not be present in the blood for several weeks to a few months following infection. Rapid HIV tests, done on blood or oral fluids, are antibody tests.

The second type of HIV test looks for the HIV virus itself (often called an HIV RNA or viral load). This test will detect the HIV virus and become positive shortly after infection (as early as 5 days), so it is an important test for diagnosing those recently infected with HIV.

The normal HIV antibody (EIA) blood test can come back negative or indeterminate for someone with acute HIV infection. However, the HIV RNA will be positive during acute infection. A negative or indeterminate HIV antibody test and a positive RNA test strongly suggests acute HIV infection.

The HIV EIA and Western blot, which are usually negative or indeterminate during acute HIV infection, usually become positive over the next 1 to 3 months. If both tests are positive, then HIV infection probably occurred several weeks to months prior to testing.

If you are concerned that you might be very newly infected with HIV, you can go to any North Carolina Public Health Department or STD Clinic and tell them you are concerned about acute HIV infection, or contact the UNC Acute HIV Infection Program at 919-966-8533.

Testing for acute HIV infection

If you have had oral, vaginal or anal sex without a condom and have been diagnosed with an STD or been sick with a viral illness, you should get tested for acute HIV infection.

All publicly funded testing facilities (such as health departments and STD clinics) throughout North Carolina can order HIV RNA testing on negative HIV antibody tests. UNC Hospital also performs RNA testing on all negative HIV antibody EIA tests.

However, whether you are tested at UNC hospitals, a health department, a private doctor's office or any health care facility, if you suspect or know you have been exposed to HIV and/or are experiencing symptoms seen with acute HIV infection, request an HIV RNA test to be done along with the HIV antibody test.

No matter where you get tested, it is very important to let your provider know that you may have been recently infected with HIV and you would like to be tested for acute HIV.

If you test positive, please make an appointment with an HIV provider for counseling and care; the facility where you tested can help you with a referral to an HIV clinic.

If you test negative for HIV, remember to take measures to prevent yourself from becoming infected with HIV, a lifelong chronic disease.