Last reviewed: October 2017
Last updated: July  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • exposure to HIV within past 72 hours
  • breakage, slippage, or non-usage of a condom
  • history of ejaculation from source
  • trauma or skin break
  • genital ulcers
  • source from high-risk group for HIV infection
  • source from geographical area with high HIV prevalence
  • detectable HIV viral load in source
  • high-risk sexual history in exposed person

Other diagnostic factors

  • history of negative HIV test in source
  • source with hepatitis co-infection
  • antiviral HIV resistance in source
  • current prescription or non-prescription medications
  • history of drug allergies
  • flu-like illness

Risk factors

  • blood transfusion from HIV-positive donor
  • sharing injecting equipment
  • needlestick injury
  • receptive anal intercourse
  • receptive vaginal intercourse
  • mucous membrane exposure
  • insertive anal intercourse
  • insertive vaginal intercourse
  • receptive oral sex (fellatio)

Diagnostic investigations

1st investigations to order

  • HIV antigen/antibody blood test (blood ELISA or EIA)
  • rapid point of care (POCT) HIV test
  • renal function tests
  • serum aspartate aminotransferase or alanine aminotransferase
  • hepatitis B serology
  • hepatitis C serology
  • syphilis serology
  • pregnancy test
Full details

Investigations to consider

  • HIV viral load if symptoms of HIV seroconversion
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Genitourinary and HIV Specialist Registrar

Department of HIV

Harrison Wing

Guy’s and St Thomas Hospital NHS Foundation Trust

London

UK

Disclosures

MJL declares no competing interests.

HIV consultant and Honorary Senior Lecturer KCL

Department of HIV

Harrison Wing

Guy’s and St Thomas Hospital NHS Foundation Trust

London

UK

Disclosures

JF has received scientific grants from Gilead Sciences and Merck.

Peer reviewers VIEW ALL

Clinical Director

HIV/AIDS Services

Royal Free Hampstead NHS Trust

London

UK

Disclosures

MJ declares that she has no competing interests.

Chief Medical Officer

Foundation for Innovative New Diagnostics (FIND)

Campus Biotech

Geneva

Switzerland

Disclosures

Not disclosed.

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