Aa
please help.
Hello Dr.
I would like to know the following. I had an Abbott RealTime HIV-1 Qualitative Assay Dried Blood Spot test for HIV 1. My results were negative.
My last exposure was last November.
The test has a specificity of 100 %1. On the results its says that: The Limit of detection for this assay is 2500 copies/ml in whole blood using the dried blood spot procedure (which is what I did).
1. Am I right to say that, if a person were to have had an HIV infection and that person caught HIV over a year ago, then surely the there would be more than 2500 copies/ml of the virus in that person's blood, because the virus will have been replicating and therefore it would be detected by the test. Correct?
2. I just read about undetectable viral loads, and was just wondering, that without medication etc, one wouldn't have an undetectable viral load because the virus would be constantly replicating and it is the medicine that inhibits the viral replication. Correct?
3. Have you ever seen/heard of a patient where they were not on medication but had an undetectable viral load?
4. And does undetectable mean truly undetectable, or is this test that detects 2500 copies/ml in blood always going to produce a reactive results if that person were infected as it is such a sensitive test? The specificity is 100 %1
I think that it depends on what test is doing the measuring, and I think 2500 copies/ml is a sensitive test.
I have had negative antibody tests as well as HIV1/HIV2/HBV and HCV RNA tests which pools the samples (the one that screens blood in the Uk). But I wanted this test because it is licensed for testing for Group N which although is so rare I just wanted to make sure.
5. Should I not worry that I may have an undetectable viral load and so the test would not be reactive?
thanks
I would like to know the following. I had an Abbott RealTime HIV-1 Qualitative Assay Dried Blood Spot test for HIV 1. My results were negative.
My last exposure was last November.
The test has a specificity of 100 %1. On the results its says that: The Limit of detection for this assay is 2500 copies/ml in whole blood using the dried blood spot procedure (which is what I did).
1. Am I right to say that, if a person were to have had an HIV infection and that person caught HIV over a year ago, then surely the there would be more than 2500 copies/ml of the virus in that person's blood, because the virus will have been replicating and therefore it would be detected by the test. Correct?
2. I just read about undetectable viral loads, and was just wondering, that without medication etc, one wouldn't have an undetectable viral load because the virus would be constantly replicating and it is the medicine that inhibits the viral replication. Correct?
3. Have you ever seen/heard of a patient where they were not on medication but had an undetectable viral load?
4. And does undetectable mean truly undetectable, or is this test that detects 2500 copies/ml in blood always going to produce a reactive results if that person were infected as it is such a sensitive test? The specificity is 100 %1
I think that it depends on what test is doing the measuring, and I think 2500 copies/ml is a sensitive test.
I have had negative antibody tests as well as HIV1/HIV2/HBV and HCV RNA tests which pools the samples (the one that screens blood in the Uk). But I wanted this test because it is licensed for testing for Group N which although is so rare I just wanted to make sure.
5. Should I not worry that I may have an undetectable viral load and so the test would not be reactive?
thanks
MEDICAL PROFESSIONAL
Re-read the closing paragraph of my last reply. Any more "yes but", "what if", or "did you really understand" questions will result in immediate deletion of the entire thread.
Thank you Dr. Perhaps you could just answer this.
Do you believe with your knowledge of science and expertise that the RNA Multiplex test as well as DUO tests and antibody tests would be reactive if there were a rare subtype or Group like Group N because all groups and subtypes have only very minor genetic differences.
And if you were me, with all your medical knowledge would you move be totally confident that you are not infected with HIV?
Do you believe with your knowledge of science and expertise that the RNA Multiplex test as well as DUO tests and antibody tests would be reactive if there were a rare subtype or Group like Group N because all groups and subtypes have only very minor genetic differences.
And if you were me, with all your medical knowledge would you move be totally confident that you are not infected with HIV?
MEDICAL PROFESSIONAL
1) No, I have not. But that's irrelevant. I also haven't seen anyone get hit by lightning, but it happens sometimes.
2) The tests are reliable. There are no unreliable HIV tests on the market.
3) Viral load and copy number are the same thing.
4) Group N is too rare to worry about.
5) I can't guarantee it, nor can I guarantee you won't get hit by a meteorite. But the odds are too low to obsess and worry about.
6) No, I have not. I'm sure it has never happened.
That's all for this thread. You can't expect to keep returning with every additional minor nuance question that comes up. Accept the science and the reasonsed reassurance and move on.
2) The tests are reliable. There are no unreliable HIV tests on the market.
3) Viral load and copy number are the same thing.
4) Group N is too rare to worry about.
5) I can't guarantee it, nor can I guarantee you won't get hit by a meteorite. But the odds are too low to obsess and worry about.
6) No, I have not. I'm sure it has never happened.
That's all for this thread. You can't expect to keep returning with every additional minor nuance question that comes up. Accept the science and the reasonsed reassurance and move on.
I was told that RNA tests pick up all subtypes of HIV and groups, but I believe that the Multplex test is only licensed for Groups M and O.
Thank you Dr. My exposures were unprotected oral sex giving and receiving (given oral sex only 10 times maximum to 6 men but received it about 30 times from about 8 men and protected anal sex where I was on top 10 times with 5 men)
1. I note you have said HIV is transmitted rarely through oral sex. Have you ever seen a case where the person caught HIV (either form giving oral sex or receiving oral sex - both people acting out the oral sex being men)
2. I have had RNA HIV1/HIV2/HCV/HBV Multiplex tests, DUO tests, BISPOT Immunocomb HIV1/HIV2, Determine DUO tests, VIDAS HIV1/HIV2 DUO quick, INSTI antibody tests. - everything negative. Are these reliable tests? The Multiplex is carried out by the blood service, so it must be good. As for the other ones, all my research seems to say they are highly accurate and very reliable tests.
Determine DUOS were taken after 28 days, INSTI tests after 3 months, 6th months and I had the Determine test, VIDAS and BISPOT carried out last week and the Dried blood spot test too. (roughly 14 months since my last exposure)
This dried blood spot test is cited as the Abbott Early Detection: HIV-1 Qualitative Real Time PCR DNA/RNA. It isn't a viral load test I believe.
3. Are copies per blood different to viral load? I.e having 5000 copies in ones blood is irrelevant to their viral load?
4. I just worried about Group N which I believe is to very rare with only a handful of cases worldwide. With the combination of tests, am I 110% certain that I am not infected with HIV?
5. I have read that tests say they are 99.8% accurate - how can you be certain that I do not have HIV, if each tests are not 100 accurate? or is my combination of tests totally accurate?
6. Lastly, Have you ever heard of(or experienced) a patient who had the combination of tests that I have had all giving negative results in fact actually being positive?
1. I note you have said HIV is transmitted rarely through oral sex. Have you ever seen a case where the person caught HIV (either form giving oral sex or receiving oral sex - both people acting out the oral sex being men)
2. I have had RNA HIV1/HIV2/HCV/HBV Multiplex tests, DUO tests, BISPOT Immunocomb HIV1/HIV2, Determine DUO tests, VIDAS HIV1/HIV2 DUO quick, INSTI antibody tests. - everything negative. Are these reliable tests? The Multiplex is carried out by the blood service, so it must be good. As for the other ones, all my research seems to say they are highly accurate and very reliable tests.
Determine DUOS were taken after 28 days, INSTI tests after 3 months, 6th months and I had the Determine test, VIDAS and BISPOT carried out last week and the Dried blood spot test too. (roughly 14 months since my last exposure)
This dried blood spot test is cited as the Abbott Early Detection: HIV-1 Qualitative Real Time PCR DNA/RNA. It isn't a viral load test I believe.
3. Are copies per blood different to viral load? I.e having 5000 copies in ones blood is irrelevant to their viral load?
4. I just worried about Group N which I believe is to very rare with only a handful of cases worldwide. With the combination of tests, am I 110% certain that I am not infected with HIV?
5. I have read that tests say they are 99.8% accurate - how can you be certain that I do not have HIV, if each tests are not 100 accurate? or is my combination of tests totally accurate?
6. Lastly, Have you ever heard of(or experienced) a patient who had the combination of tests that I have had all giving negative results in fact actually being positive?
MEDICAL PROFESSIONAL
Welcome to the forum.
I don't have personal experience with that test, which is not normally done for HIV diagnosis or screening. However, your negative antibody test proves you didn't catch HIV, assuming it was done at least 6 weeks after the exposure; and the combination of a negative viral load test plus negative antibody any time after 4 weeks is 100% proof.
1-3) Yes, probably there would be >2500 copies -- but not necessarily. Some people have undetectable viral loads without treatment. At 1 year, this negative result by itself does not exclude HIV infection. But as I said, the combination of all your test results does. I have "heard of" many such patients.
4) Undetectable means only that the viral load is below the limit of the test being used. If you are correctly citing the test's performance, then in theory you could have a viral load of 2,499.
5) You should not be worried. Clearly you do not have HIV and you should stop testing for it.
Regards-- HHH, MD
I don't have personal experience with that test, which is not normally done for HIV diagnosis or screening. However, your negative antibody test proves you didn't catch HIV, assuming it was done at least 6 weeks after the exposure; and the combination of a negative viral load test plus negative antibody any time after 4 weeks is 100% proof.
1-3) Yes, probably there would be >2500 copies -- but not necessarily. Some people have undetectable viral loads without treatment. At 1 year, this negative result by itself does not exclude HIV infection. But as I said, the combination of all your test results does. I have "heard of" many such patients.
4) Undetectable means only that the viral load is below the limit of the test being used. If you are correctly citing the test's performance, then in theory you could have a viral load of 2,499.
5) You should not be worried. Clearly you do not have HIV and you should stop testing for it.
Regards-- HHH, MD
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