A male client seeks medical evaluation for fatigue, night sweats, and a 20-lb weight loss in 6 weeks. To confirm that the client has been infected with the human immunodeficiency virus (HIV), the nurse expects the physician to order:
A. E-rosette immunofluorescence
B. Quantification of T-lymphocytes.
C. Enzyme-linked immunosorbent assay (ELISA).
D. Western blot test with ELISA.
Correct Answer: D. Western blot test with ELISA.
HIV infection is detected by analyzing blood for antibodies to HIV, which form approximately 2 to 12 weeks after exposure to HIV and denote infection. The Western blot test — electrophoresis of antibody proteins — is more than 98% accurate in detecting HIV antibodies when used in conjunction with the ELISA. It isn’t specific when used alone.
Option A: E-rosette immunofluorescence is used to detect viruses in general; it doesn’t confirm HIV infection.
Option B: Quantification of T-lymphocytes is a useful monitoring test but isn’t diagnostic for HIV.
Option C: The ELISA test detects HIV antibody particles but may yield inaccurate results; a positive ELISA result must be confirmed by the Western blot test.