HIV Variants: Can Rapid Tests Detect All Types?

HIV-1, HIV-2, latest mutation VB

Hello, doctor.
I would like to inquire about the recent HIV variant VB.
Is it classified as a mutation of HIV-1? Can our current blood and oral rapid tests detect all types of HIV variants (including HIV-1, HIV-2, and VB)? The rapid tests indicate whether there is an HIV infection, but they do not specify which type of HIV virus it is, correct?

Qiu Xiansheng, 30~39 year old female. Ask Date: 2022/03/21

Dr. Liao Zhongxin reply Internal Medicine

1.
Yes, it belongs to the HIV-1, subtype B variant (which is prevalent in Europe, particularly in the Netherlands, with at least 109 cases reported).

2.
The currently used testing tools can still detect the VB mutant.

3.
The VB mutant is characterized by causing infected individuals to progress more rapidly to the late stage (AIDS), leading to a faster decline in CD4 counts and an increased likelihood of transmission.
Therefore, experts recommend that high-risk populations should undergo regular HIV testing, and if infection is confirmed, treatment should be initiated as soon as possible.
Current research indicates that antiretroviral medications are effective.

Reply Date: 2022/03/21

More Info

Understanding HIV variants and the effectiveness of rapid tests is crucial for individuals concerned about their health, especially in light of the emergence of new strains like the HIV-1 variant VB. To address your question, yes, the VB variant is indeed a mutation of the HIV-1 virus, specifically a subtype that has been identified in certain regions, particularly in Europe.
Rapid tests, including blood and oral fluid tests, are designed to detect the presence of HIV antibodies and antigens. The most commonly used rapid tests can typically identify both HIV-1 and HIV-2 infections. However, the detection of specific variants, such as the VB variant, depends on the sensitivity and specificity of the test used. Most modern rapid tests are capable of detecting a wide range of HIV variants, including those that are more prevalent, like the M group, which encompasses the majority of HIV infections globally.

The rapid tests work by identifying the immune response to the virus (antibodies) or the virus itself (antigens). If a rapid test returns a positive result, it indicates that the individual has been exposed to the virus, but it does not specify which type or variant of HIV is present. For definitive identification of the specific strain or variant, additional laboratory testing, such as viral load testing or genotyping, may be necessary.

In terms of the VB variant, it is important to note that while rapid tests can detect the presence of HIV, they may not always provide information on the specific strain. However, the current testing methods, including the rapid tests, are generally effective in identifying the presence of the virus, regardless of the specific variant.
For individuals at higher risk or those who have had potential exposure to HIV, regular testing is recommended. If you are concerned about a specific variant or if you have had a high-risk exposure, consulting with a healthcare provider for further testing and evaluation is advisable. They may recommend additional tests, such as an HIV RNA test (RT-PCR), which can detect the virus directly and provide more information about the specific strain.

In summary, while rapid tests are effective in detecting HIV infections, including many variants, they do not provide detailed information about the specific type of HIV present. For comprehensive understanding and management of HIV, especially in the context of emerging variants like VB, it is essential to engage in regular testing and consult healthcare professionals for personalized advice and treatment options.

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