Notifiable disease reporting
When and how clinicians should notify SA Health of the occurrence of notifiable diseases under the South Australian Public Health Act 2011
Last updated: March 2014
A positive screen using a fourth generation HIV screening assay provides a presumptive diagnosis.
Is not routinely used as a screening test to diagnose HIV.
Partner Notification is required and should be conducted by a specialist partner notification officer or experienced HIV clinician
The health advisor should provide information on support services.
Patients should be seen for follow up to:
Patients with HIV are encouraged to maintain a relationship with their usual GP and to continue regular STI screening at recommended intervals
Non occupational Post Exposure Prophylaxis following a possible exposure to HIV should be managed in accordance with local and national guidelines.
Discuss all cases of suspected HIV seroconversion with a senior doctor.
Seroconversion is a highly infectious stage and may be the only clinical presentation before AIDS.
Primary HIV infection (PHI) is the clinical syndrome associated with the development of HIV antibodies.
PHI occurs in 80% of individuals 2 to 4 weeks after HIV infection. Therefore suspect if high-risk exposure within 2 months and if clinical symptoms include any of the following:
Rarer presentations include aseptic meningitis, weight loss or an AIDS-defining infection such as PJP.
Serological HIV antibody test 4th generation or combo test (HIV Ab with page 24 Ag)
If initial test negative & you suspect PHI it is essential to bring back in 7 days for a repeat test.
Note: a second negative HIV test at one week confidently excludes that particular clinical presentation as a seroconversion illness, a 3 month window period test is still needed to exclude asymptomatic seroconversion.
Secondary syphilis, other acute viral infections (EBV/ CMV/ HSV)
Patients may rarely require admission for symptom control, discuss with a senior doctor.
Some symptoms associated with seroconversion may need HIV treatment.
Advice
Abstain from all sex until results are known (consider highly infections).
For further information on HIV diagnosis and management including post exposure prophylaxis contact Adelaide Sexual Health Centre.
These guidelines are based on review of current literature, current recommendations of the United States Centers for Disease Control and Prevention, World Health Organization, the British Association for Sexual Health and HIV and local expert opinion.
They are written primarily for use by Adelaide Sexual Health Centre staff and some flexibility is required in applying them to certain private practice situations.