Anti-HIV

[NurseyPoo7]

I have a patient who was admitted to ICU for resp distress on Bipap and was later transferred to med surg. Hes on precautionary TB isolation, although his PPD was negative and f/u CXR was also negative. There was also suspicion maybe this was PCP - pt refusing to be tested for HIV. But I saw in his labs there was one called "Anti-HIV" and the result said "Reactive" and in the notes it said the sample was sent to the state laboratory for further testing. I've looked in my lab test book from nursing school and I dont see a test entitled "Anti-HIV".

Does anyone know about this and what it means?

[Jaybird310]

It's my understanding that an Anti-HIV is merely an HIV test to see if there are HIV antibodies present. Therefore if the results said reactive then I assume the patient is HIV Positive. Someone correct me if I'm wrong.

[SuesquatchRN, BSN, RN]

It's my understanding that an Anti-HIV is merely an HIV test to see if there are HIV antibodies present. Therefore if the results said reactive then I assume the patient is HIV Positive. Someone correct me if I'm wrong.

It depends on the test. The ELISA isn't as selective as the Western Blot, but it is more sensitives.

Testing positive for antibodies can just mean exposure, which is why an ELISA is confirmed with a Western Blot.

The OP can not assume anything about the patient's HIV status from the information given.

[heron, ASN, RN]

Consider talking to your risk manager ... HIV testing without consent is a bit iffy.

[Jaybird310]

It depends on the test. The ELISA isn't as selective as the Western Blot, but it is more sensitives.

Testing positive for antibodies can just mean exposure, which is why an ELISA is confirmed with a Western Blot.

The OP can not assume anything about the patient's HIV status from the information given.

Thanks for the more in depth clarification, I'm not up to speed on the levels of HIV testing. But it remains an Anti-HIV test is an HIV test. Now I'm just wondering why they would do an HIV test when the patient according to the OP refused....

[SuesquatchRN, BSN, RN]

I have no idea of the legalities of performing the test. I certainly understand that, if they're looking for opportunistic infections, they'd want to know if there is an opportunity - immune system compromise 2o HIV.

[NurseyPoo7]

Well, I had seen in the labs the Anti HIV was reactive. The Dr came in the next morning and ordered "HIV test" but THAT is when the patient refused. I'm under the assumption the "Anti-HIV" test doesnt require a signed consent but the actual HIV test does.

[ErraticThinker]

It might vary state to state. Here in Massachusetts, you can't run the test without specific consent. the provider has to obtain the consent. So the fact he's refusing to be tested but there's already a test result that potentially means he's positive. technically it means he's been exposed but its usually followed up.

It's kind of strange though because there are a string of other labs they could run to figure out if he's immunosuppressed, or if theres some kind of infectious process. I think an ID consult would be in order.

[DA314]

This is interesting. You'd think someone would want to know if they were HIV + so they could get on meds to prolong their life.

Maybe ignorance is bliss though?

[TheCommuter, BSN, RN]

This is another good reason why we must treat every patient as if they've got an infectious disease. We really are not armed with all the information we truly need regarding the health statuses of these people, and this could be to our detriment. I've even witnessed some healthcare workers who have obtained fingersticks without gloves or started IVs with their bare hands.

[SuesquatchRN, BSN, RN]

This is interesting. You'd think someone would want to know if they were HIV + so they could get on meds to prolong their life.

Maybe ignorance is bliss though?

It's possible he knows and doesn't want the stigma affecting his care.

[nerdtonurse?, BSN, RN]

And let's not forget denial. I've seen women with open tumors in their breast, literally dying from breast cancer, who was adamant that they just had "a chest cold" to explain the SOB from the mets to the lung....