HIV (Human Immunodeficiency Virus) is a virus that attacks / damages the body's immune system so that the body's ability to fight infection / disease becomes weak.

HIV testing can be carried out on someone with the following indications:

1. Every adult, child, teenager with a medical condition suspected of HIV infection, especially with a history of Tuberculosis (TB) and venereal disease.

2. Antenatal care for pregnant women & women giving birth

3. Newborn babies from HIV-infected mothers

4. Children whose family history is unknown

5. Exposure to or potential HIV infection through contaminated needles, receiving repeated transfusions & other reasons

6. PLWHA couples.

Apart from the results of physical examinations and subjective complaints experienced by people infected with HIV or PLWHA, laboratory examinations play a role in screening, diagnosis, care and treatment of PLWHA. All of this is necessary in order to create an appropriate management plan for handling HIV/AIDS, so that the virus can be controlled, health status improves and reduces the possibility of transmitting the virus to other people.

To help screen, diagnose and monitor the health status of PLWHA and the success of HIV treatment, several laboratory tests can be carried out, including:

• HIV test Screening: carried out by taking a blood sample and examining it using three different examination methods.

• CD4 count: a parameter to assess the risk of opportunistic infections and the functioning of the immune system.

• CD4 percentage: said to be more stable than CD4 count over a period of time. However, the CD4 count better describes the work of the immune system compared to the CD4 percentage.

• HIV RNA: to assess response to HIV treatment

• Complete Hematology: a frequently requested examination, as it can reveal infections, anemia and other medical problems.

• Sexually Transmitted Disease (STD) Screening: screening for syphilis, gonorrhea and chlamydia. The presence of STDs can increase the risk of transmitting HIV to other people.

• PAP smear (Cervical and Anal): abnormal cell growth in the cervix (women) and anus (men and women) which often occurs in PLWHA can degenerate malignantly if not treated early.

• Hepatitis A, B and C tests: in PLWHA, co-infection with hepatitis is not uncommon.

• Tuberculosa Test: in PLWHA, untreated TB can be fatal. Detection and treatment of TB is important to prevent transmission of TB to other people.

• Toxoplasmosis screening: Toxoplasmosis can be an opportinistic infection that can be fatal for PLWHA.

• Lipid Profile Examination (Cholesterol and Triglycerides): several HIV drugs have an effect on lipid metabolism. High lipid levels tend to cause other medical problems, including heart problems.

• Fasting Glucose Levels: some HIV drugs can increase blood glucose levels and potentially cause complications, such as diabetes mellitus.

• Pregnancy test: so that efforts can be made immediately to reduce the risk of HIV transmission to the baby.

Preparation of patients and examination materials.

Before taking a blood specimen, patients are expected to fast for 10-12 hours beforehand. Pap smears can be carried out starting on the 3rd day of menstruation/last day of menstruation and for the previous 2 days do not have intimate relations. The types of samples needed are urine and blood from a vein.

Author: Lely Nurhayati, Dr (PRAMITA Clinical Laboratory Medical Services Doctor, Surabaya Mulyosari branch)