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6A                                                  Skills workshop:                                                  Scre...
SK ILLS WORKSHOP : SCREENING TESTS FOR HIV   103   red bar in the Patient window must be          E. Management if the HIV...
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Adult HIV: Skills workshop screening tests for HIV

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Adult HIV was developed by doctors and nurses with wide experience in the care of adults with HIV, under the auspices of the Desmond Tutu HIV Foundation at the University of Cape Town. It covers: introduction to HIV infection, management of HIV-infected adults at primary-care clinics, preparing patients for antiretroviral (ARV) treatment, ARV drugs, starting and maintaining patients on ARV treatment, opportunistic infections

Publié dans : Formation, Santé & Médecine
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Adult HIV: Skills workshop screening tests for HIV

  1. 1. 6A Skills workshop: Screening tests for HIV B. The method of performing Objectives the HIV rapid test When you have completed this unit you 1. Clean a fingertip with an alcohol swab and should be able to: allow the finger to dry. • Screen a patient for HIV. 2. Remove a test strip from the foil cover. • Interpret the results of the screening test. 3. Prick the skin of the fingertip with a lancet. Wipe the first drop of blood away with aWhenever possible, patients should be offered sterile gauze swab.and encouraged to accept screening for HIV. 4. Collect the next drop of blood with theAn HIV rapid test can be used in any clinic, as EDTA tube. Either side of the tube can beno sophisticated equipment is required. Prior used to collect blood. Fill the tube fromto testing, patients need to be counselled and the tip to the first black circle (i.e. 50 μl ofconsent must be obtained. blood). Avoid collecting air bubbles. 5. Apply the 50 μl of blood from the EDTA tube onto the sample pad marked with anA. Equipment needed to arrow on the test strip.perform an HIV rapid test 6. Wait one minute until all the blood has1. The Abbott Determine HIV-1/2 Whole been absorbed into the sample pad and Blood Assay. Each kit contains 10 cards then apply one drop of Chase Buffer. It is with 10 tests. The Chase Buffer (2.5 ml important that the bottle is held vertically bottle) is supplied with the kit. (upside down) above the test strip when2. EDTA capillary tubes marked to indicate the drop of buffer is dropped onto the 50 μl, lancets, alcohol swabs and sterile sample pad. gauze swabs. These are not supplied with 7. Wait a minimum of 15 minutes and then the kit. read the results. The maximum waiting time for reading the test is 20 minutes.The kit needs to be stored at room temperature After 20 minutes the test becomes invalid.between 2 °C and 30 °C. Storage in a fridge isrequired during summer. The kit cannot beused after the expiry date. C. Reading the results of the HIV rapid test 1. Positive: A red bar will appear within both the Control window and the Patient window on the test strip. Any visible
  2. 2. SK ILLS WORKSHOP : SCREENING TESTS FOR HIV 103 red bar in the Patient window must be E. Management if the HIV regarded as positive. The result is positive rapid test is positive even if the patient bar appears lighter or 1. Explain to the patient that the first darker than the control bar. screening test for HIV is positive but that2. Negative: A red bar will appear within the this should be confirmed with a second test. Control window and but no red bar is seen 2. Proceed with a second test using a kit from in the Patient window. a different manufacturer.3. Invalid: If no red bar appears in the 3. If the second test is also positive, the Control window, even if a red bar is visible patient is HIV positive. in the Patient window. The result is invalid 4. Proceed with post-test counselling for a and the test must be repeated. patient with a positive test.D. The interpretation of the HIV rapid test F. Management if the first HIV rapid testThe test is a specific test for HIV and will is positive but the second is negativebecome positive when there are antibodies 1. A blood sample for an ELISA test must beagainst HIV (the virus that cause AIDS) in sent to the laboratory.the blood. 2. The patient must be informed that1. A positive test indicates that a person has the results of the HIV rapid tests are antibodies against HIV (HIV positive). inconclusive and that a laboratory test Therefore the person is infected with HIV. is required to finally determine her HIV2. A negative test indicates that a person status. does not have antibodies against HIV 3. If the ELISA test is positive the patient is (HIV negative). Therefore the person is HIV positive (i.e. HIV infected). not infected with HIV, unless infected very 4. If the ELISA test is negative the patient is recently and the HIV antibodies have not HIV negative (i.e. not HIV infected). appeared yet. 5. Proceed with appropriate counselling.