HIV - Western Blot

Immunity

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No Fasting Required

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Detect infection with Human Immunodeficiency Virus

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HIV - Western Blot Test Information Guide

Why is it done?
- Detects antibodies to Human Immunodeficiency Virus (HIV) in blood serum, confirming HIV infection through protein pattern analysis
- Used as a confirmatory test following a positive initial screening (such as HIV antibody screening or rapid HIV test)
- Helps establish definitive HIV diagnosis in patients with clinical symptoms or known exposure
- Performed during initial evaluation of suspected HIV infection or as part of standard infectious disease workup
- May be used to differentiate between HIV-1 and HIV-2 infections in some laboratory protocols
Normal Range
- Negative Result: No visible bands or only a single band at the albumin position indicates no HIV antibodies detected; indicates absence of HIV infection
- Positive Result: Two or more bands present at specific locations (gp120/gp160, gp41, and/or p24) indicates HIV infection confirmed
- Indeterminate/Inconclusive Result: One band or atypical band pattern present; requires repeat testing at a later date or alternative confirmatory testing (HIV-1/HIV-2 differentiation immunoassay or HIV nucleic acid test)
- Units of Measurement: Qualitative assay (presence or absence of antibody bands); no numerical values
Interpretation
- Negative Western Blot: Combined with negative initial HIV screening indicates very low likelihood of HIV infection; may need repeat testing if exposure occurred within the window period (typically 3-12 weeks after infection when antibodies are still developing)
- Positive Western Blot: Confirms HIV infection; indicates patient has developed antibodies to HIV proteins; warrants immediate clinical evaluation, CD4 count assessment, viral load testing, and initiation of antiretroviral therapy discussion
- Indeterminate Result: Requires follow-up testing; may indicate early infection during window period, non-specific antibodies, autoimmune conditions, vaccinations, or laboratory error; repeat testing recommended after 1-2 weeks; HIV RNA nucleic acid test (NAT) may be performed for definitive status
- Factors Affecting Results: • Window period after exposure (antibodies may not yet be present) • Recent immunizations or vaccinations • Autoimmune diseases or conditions • Cross-reactivity with other viral antibodies • Technical errors or specimen collection problems • Advanced AIDS with severely compromised immune system (may produce weak bands)
- Clinical Significance: Confirms HIV diagnosis when positive; helps guide treatment decisions, monitoring strategies, and counseling; essential for determining patient's immune status and prognosis; results impact sexual partners and family planning considerations
Associated Organs
- Primary Organ System: Immune system (particularly T lymphocytes, macrophages, and other white blood cells); blood and lymphoid tissues
- Conditions Associated with Abnormal Results: • Human Immunodeficiency Virus (HIV) infection • Acquired Immunodeficiency Syndrome (AIDS) • Opportunistic infections (Pneumocystis pneumonia, tuberculosis, cryptococcosis, cytomegalovirus) • HIV-associated malignancies (lymphomas, Kaposi sarcoma) • HIV encephalopathy and neurological complications • Immune reconstitution inflammatory syndrome (IRIS)
- Diseases Diagnosed/Monitored: HIV-1 infection (most common globally), HIV-2 infection (primarily West Africa), progression to AIDS, treatment response to antiretroviral therapy
- Potential Complications of Abnormal Results: • Progressive immunosuppression and CD4 count decline • Severe opportunistic infections and sepsis • Multi-organ failure affecting liver, kidney, lungs, and central nervous system • Development of malignancies • Cardiovascular complications and increased risk of heart disease • Transmission to sexual partners or through blood exposure • Psychosocial impacts including depression and social stigma
Follow-up Tests
- Confirmatory/Differential Testing: HIV-1/HIV-2 differentiation immunoassay, HIV-1 nucleic acid test (NAT/HIV RNA viral load), p24 antigen testing for acute infection detection
- Baseline Assessment Tests (after positive confirmation): CD4 T-cell count, HIV-1 RNA viral load, HIV resistance testing/genotyping, hepatitis B and C serology, syphilis testing, tuberculosis screening, baseline metabolic panel
- Ongoing Monitoring: CD4 count every 3-6 months, HIV RNA viral load every 3-6 months during initial treatment and annually on stable antiretroviral therapy, liver and kidney function tests, lipid panel
- Partner/Contact Notification Testing: Sexual partners and needle-sharing contacts should receive HIV screening including fourth-generation antigen/antibody tests or HIV NAT
- Complementary Investigations: Lymph node biopsy (if lymphadenopathy present), opportunistic infection screening based on CD4 count, HLA-B*5701 testing for abacavir use, imaging studies if clinical symptoms warrant
Fasting Required?
- Fasting Status: No - Fasting is NOT required for HIV Western Blot testing
- Medication Instructions: No medications need to be withheld or avoided; test can be performed regardless of current antiretroviral therapy or other medications
- Patient Preparation Requirements: • Standard blood draw precautions (arm clean and dry) • Wear comfortable clothing with loose-fitting sleeves for easy blood draw access • Stay well hydrated before testing to improve venipuncture success • Inform healthcare provider of any bleeding disorders or anticoagulant use • Emotional support available if needed due to test implications • Can eat and drink normally before and after the test • No specific time of day restrictions
- Specimen Collection: Blood serum sample obtained via venipuncture into appropriate collection tube (typically serum separator tube); approximately 5-10 mL collected

How our test process works!