Funding
Testing

James Grissom
HIV Positive
Steve Sherman
Coordinator, NC AIDS Drug Assistance Program
Peter Leone, M.D.
Medical Director, HIV/STD Prevention & Care Branch
Fred Wiggins
HIV Positive
Milford Evans
Benefits Advocate
Bart Haynes, M.D.
Director, Center for HIV/AIDS Vaccine Immunology, part of the National Institutes of Health

Acute HIV Testing
AIDS Funding
AIDS Research
AIDS Volunteers

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Acute HIV Testing

Help for people with HIV/AIDS is coming in the form of rapid scientific advances, new frontiers of medicine for a new age of the disease. And it starts with testing. AIDS Advocates say no matter who you are, it's important to be tested for HIV because early detection improves your chance of survival and reduces your risk of transmitting HIV to other people.

At a state-run lab in Raleigh, technicians screen more than 100,000 blood samples each year for HIV. But before one particular type of test was available, some people with the earliest stages of the infection might not have gotten the right results.

"Our traditional ways of detecting HIV were dependent on an antibody response, so this is a period that we can miss because of that," says Dr. Peter Leone , Medical Director for the state's HIV/STD Prevention & Care Branch.

The period is called acute HIV, a four-to-eight week window when someone is infected but the immune system has not begun attacking the virus with antibodies. That makes it impossible to detect with a standard antibody test and much easier to transmit.

"As a result it is the most infectious period of HIV. Period," Dr. Leone emphasizes. "It's a very short window of time we're talking about, yet some estimates put as much as 40 to 50% of transmission occur during this acute period."

That's why, in November 2002, the state began testing for acute HIV. It was the first state in the U.S. to do so. Any blood sample that tests negative with the standard antibody test also gets the acute test, which looks for the virus itself. The program costs about $400,000 per year, just a few dollars per test.

"But when you start thinking about is it worth the extra two bucks or three bucks per test to identify people that could be missed for years, I think the overwhelming answer to that is yes," says Dr. Leone.

When technicians in the lab discover a case of acute HIV, another team of people goes to work: the disease intervention specialists. Manager Todd Vanhoy says they are the "first responders" when someone is diagnosed.

"A disease intervention specialist is basically a counselor and an investigator at the same time," Vanhoy explains. "On the investigation side, we follow up on any reports of positive STDs, basically now it's HIV and syphilis, and we follow up with the individual, refer them into care, offer counseling services to them."

Guilford County outreach worker Lloyd Mickens is sometimes the one who breaks the news.

"It's not a fun day, not a fun day at all," says Mickens. "Unless, a lot of them have the idea that they are positive, and some of them do take it fairly well, but then you have others who it's really sad. You sit and cry with them."

As hard as the job is, Todd Vanhoy says it's critical for people like Lloyd Mickens to do it quickly, in part so the infected person will not unknowingly infect anyone else. Specialists also talk with the patient about their sexual partners. North Carolina law says those partners must be told they've been exposed to HIV.

"If we can get to a person's partner quick enough we can possibly give them medicine to prevent them from ever getting the infection or developing it," Vanhoy says.

Dr. Peter Leone says the program has identified more than 100 people with acute HIV and possibly prevented hundreds more from being infected, including an unborn baby whose mother tested positive.