Читать книгу A Practical Approach to Special Care in Dentistry - Группа авторов - Страница 187

 The initial diagnostic test is the enzyme‐linked immunosorbent assay (ELISA), which detects the viral protein p24, an HIV‐1 antigen; there can be a window of up to 6 months from exposure to the virus to when it becomes detectable

 If the ELISA is positive, the HIV‐1/HIV‐2 antibody differentiation immunoassay confirmation test is applied (Western Blot, which was used prior to this test, could not differentiate between HIV‐1 and HIV‐2). If the result is negative or indeterminate, the nucleic acid test (NAT) may be employed to confirm that this is not an acute infection or a false positiveFigure 4.2.5 Pneumonia by Pneumocystis carinii as an AIDS‐defining condition.

 Rapid HIV antibody detection tests have been marketed and employ samples of oral mucosa exudate

 The immunosuppression level is established based on the concentration of CD4+ T‐cells in peripheral blood and is the best predictor available for the onset of opportunistic infections, disease progression and survival (stage 1, ≥500 cells/μL; stage 2, 200–499 cells/μL; stage 3, <200 cells/μL)

 Determining the viral load consists of quantifying the number of copies of HIV ribonucleic acid (HIV‐RNA) in peripheral blood, using the real‐time polymerase chain reaction (RT‐PCR); this test is applied as a predictor of disease progression and to select the antiretroviral regimen

 A patient is considered to be in the AIDS stage when they have <200 CD4+ T‐cells/μL, their CD4+ T‐cell count is <14% of the total or they have an AIDS‐defining condition