Stephen J. Schueler, M.D.

AIDS Evaluation

The evaluation of AIDS begins with a history and physical exam.

Physical findings in those with AIDS include:


Tests that are used to evaluate AIDS include:

Additional tests that may be used to evaluate AIDS include:

AIDS AIDS Testing

The HIV test is always positive in those who have AIDS. A specific type of white blood cell, called the CD4 T lymphocyte, is low in those who have AIDS. In order to make the diagnosis of AIDS, the CD4 T lymphocyte count should be less than 200.

HIV Treatment Monitoring
Blood tests:

  • You should have blood tests for HIV viral load and CD4 count every 3-4 months.
  • HIV viral load: measures the amount of virus in the bloodstream
    • Your medication is working properly if your viral load remains low.
    • Best lab value for assessing the success of HAART; drugs should suppress this level to less than 50 copies per milliliter
    • If your viral load is high, your doctor may change the dose of your HIV medication, replace one of your medications, or add a new medication.
  • CD4 count: measures the number of CD4 white blood cells per cubic millimeter of blood

AIDS HIV Testing

There are a variety of ways to test for HIV infection. Not all individuals who are HIV positive will also test positive for AIDS.

HIV tests detect one or more of the following:

  • Antibodies to HIV:
  • Viral p24 antigen test:
    • Used for very early detection in cases of blood contamination
  • Viral nucleic acid testing:
    • Used for very early detection in cases of blood contamination

Antibodies to HIV
The two types of HIV antibody tests are the:

The ELISA is a screening test: it is reported as positive or negative. The ELISA test may be falsely positive in:

The Western blot test is used to confirm HIV infection in someone who is ELISA positive. If the Western blot is negative (and remains so for 6 months) HIV infection is not present.

p24 Antigen Testing
HIV antigen tests detect the p24 antigen, which is a protein that is produced by the HIV virus. This test is used to:
  • Help in the diagnosis of AIDS
  • Monitor the response to treatment
  • Early detection of HIV virus in blood donors
  • Detect the presence of HIV in the blood of newborns, born to mothers who have HIV

Viral Nucleic Acid Testing
Nucleic acids are the building blocks of DNA and RNA. The HIV nucleic acid test detects the presence of HIV nucleic acids. This test is used to:
  • Monitor the response to treatment
  • Early detection of HIV virus in blood donors
  • Detect the presence of HIV in the blood of newborns, born to mothers who have HIV

Continue to AIDS Treatment

Last Updated: Nov 9, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
Copyright DSHI Systems, Inc. Powered by: FreeMD - Your Virtual Doctor

PubMed AIDS References
  1. Aberg JA, Gallant JE, Anderson J, et al: Primary care guidelines for the management of persons infected with human immunodeficiency virus: recommendations of the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis 2004 Sep 1; 39(5): 609-29. [15356773]
  2. Aberg JA, Kaplan JE, Libman H, Emmanuel P, Anderson JR, Stone VE, Oleske JM, Currier JS, Gallant JE; HIV Medicine Association of the Infectious Diseases Society of America. Primary care guidelines for the management of persons infected with human immunodeficiency virus: 2009 update by the HIV medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2009 Sep 1;49(5):651-81. [19640227]
  3. Chang R, Wong G, Gold J, et al: HIV-related emergencies: frequency, diagnoses, and outcome. J Gen Intern Med 1993 Sep; 8(9): 465-9. [8410417]
  4. Clumeck N: Choosing the best initial therapy for HIV-1 infection. N Engl J Med 1999 Dec 16; 341(25): 1925-6. [10601514]
  5. Hammer SM. Clinical practice. Management of newly diagnosed HIV infection. N Engl J Med. 2005 Oct 20;353(16):1702-10. [16236741]
  6. Knoll B, Lassmann B, Temesgen Z. Current status of HIV infection: a review for non-HIV-treating physicians. Int J Dermatol. 2007 Dec;46(12):1219-28. [18173512]
  7. McArthur JC, Brew BJ, Nath A. Neurological complications of HIV infection. Lancet Neurol. 2005 Sep;4(9):543-55. [16109361]
  8. Mylonakis E, Paliou M, Lally M, et al: Laboratory testing for infection with the human immunodeficiency virus: established and novel approaches. Am J Med 2000 Nov; 109(7): 568-76. [11063959]
  9. Paul SM, Sensakovic J, Podhurst LS, Morgan DH, Triano-Davis W. Managing HIV/AIDS patients. N J Med. 1998 May;95(5):55-60. [16013158]
  10. Treatment guidelines from the Medical Letter: Drugs for HIV Infection. Treat Guidel Med Lett 2004 Jan; 2(17): 1-8. [15529108]
  11. Varghese GK, Crane LR: Evaluation and treatment of HIV-related illnesses in the emergency department. Ann Emerg Med 1994. Sep. (3): 503-11. [8080146]
FreeMD is provided for information purposes only and should not be used as a substitute for evaluation and treatment by a physician. Please review our terms of use.