Indeterminate Retrovirus Infection Service (IDRIS)

We would like to see people from two main groups:

1. People whose HIV status is unclear from their blood test results so far

This includes:

• people using PrEP
• people who previously took part in HIV vaccine trials
• people whose HIV test results remain unclear for no obvious reason

Our tests are usually able to give people a definite HIV result ie that they are HIV positive or HIV negative.

2. People who control HIV to undetectable levels without antiretroviral therapy, also called spontaneous HIV-1 viral control

• Less than 1% of people living with HIV are spontaneous viral controllers, which means their immune system controls HIV without treatment.
• Although guidelines recommend all people living with HIV-1 should start antiretroviral treatment, the evidence is more limited for people who can control HIV without antiretroviral therapy. Some people in this group choose not to start treatment. In this case, referral to a specialist clinic like IDRIS will allow careful monitoring of the CD4 count, viral load and other markers.
• In current British HIV Association guidelines, best practice in the UK is for people with spontaneous HIV control to be referred to IDRIS.
  
  

What happens at the IDRIS clinic?

During your appointment we will:

• ask about your medical history
• ask for your consent for extra blood samples for specialist tests
• take bloods for both NHS and specialist tests
• ask if you are interested to volunteer to give extra blood samples for future research; this is entirely voluntary and will not affect your medical care or other tests done
  
  

Blood samples are tested for:

• HIV genetic material – both viral DNA and RNA in two labs, and using standard and specialist (“ultrasensitive”) tests
• Immune markers including T-cell activation
• Antibody tests including western blot
• Other conditions including viral hepatitis, HTLV, CMV, EBV, syphilis and autoimmune diseases
  
  

Other information about the clinic

• The clinic is run jointly by the Department of HIV and Sexual Health, Imperial College Healthcare NHS Trust and the Virus Reference Department, UK Health Security Agency.
• It is held every two months on the Ground Floor, Winston Churchill Wing, St Mary’s Hospital, London. People can be seen more quickly if the case is urgent.
• Referral is by self referral or from any clinician by emailing imperial.idris@nhs.net

Further sources of information

• HIV i-base
• British Association of Sexual Health and HIV / British HIV Association Guidelines on the use of HIV pre-exposure prophylaxis (PrEP)
• British HIV Association Guidelines on antiretroviral treatment for adults living with HIV-1 2022 (2023 interim update)
• Indeterminate HIV tests: when test results are unclear