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PCR RNA Poz/ Antibody negative--and confused
Two weeks ago I was tested at a city clinic for HIV --the immediate, finger-***** antibody test came back negative. Today I got a call from the counselor to come in; it seems that the PCR RNA test they gave me came back positive. I got retested on the spot for HIV antibodies and the test was again negative. I am partnered and play safe, and had originally (two weeks ago) gone in because I was considered about performing oral sex on someone 36 hours prior. Would the PCR RNA test register that this incident had infected me? My counselor originally told me that there were no false positives on this test and to prepare for testing positive to the antibody test --he seemed surprised when it came back negative. Then when I pressed him he conceded that he has had once case of a false positive RNA test.
Thank you for your time. I am very scared and the indeterminacy (hoping for the best, expecting the worst) is killing me.
Thank you for your time. I am very scared and the indeterminacy (hoping for the best, expecting the worst) is killing me.
For everyone's edification:
http://www.thebody.com/Forums/AIDS/SafeSex/Current/Q182199.html
http://www.thebody.com/Forums/AIDS/SafeSex/Current/Q182199.html
Ah, Strata brings up a good point. I ask this because I am unsure of the answer: is the PCR RNA test in question qualitative or quantitative? In other words, qualitative tests will simply provide a binary response: positive or negative. The quantitative tests will return a number, which represents the supposed viral load.
If the test was quantitative, it may be helpful to know the viral load it reported, as, in some cases, if a certain threshhold is not crossed, the test *may* be read to be "false positive" (if I am wrong on any of this, someone please feel free to correct me).
PCR/RNA - Regardless of your technician's experience, PCR tests DO have an elevated rate of false positives.
What was your viral load as shown by the test?
Some HIV- patients will consistently register (erroneously) a low viral load on PCR tests.
Based on the preliminary positive result from the PCR test, you will need antibody testing through 3 months post-exposure. You'll also want to practice safe sex with your partner, just to be sure.
Based on your exposure (receptive oral) and your partner's HIV- serostatus, odds seems to be in your favor that the PCR result was a false-positive.
If you are ultimately HIV+, please keep it in perspective. HIV is now a chronic disease, not the fatal disease of the past.
Best wishes!
What was your viral load as shown by the test?
Some HIV- patients will consistently register (erroneously) a low viral load on PCR tests.
Based on the preliminary positive result from the PCR test, you will need antibody testing through 3 months post-exposure. You'll also want to practice safe sex with your partner, just to be sure.
Based on your exposure (receptive oral) and your partner's HIV- serostatus, odds seems to be in your favor that the PCR result was a false-positive.
If you are ultimately HIV+, please keep it in perspective. HIV is now a chronic disease, not the fatal disease of the past.
Best wishes!
At this point, I don't know what to do --I originally went in conerned about something that had happened 36 hours earlier and the time frame of the RNA PCR test is 10+ days. So I had this counselor telling me that I must have been exposed to it recently, which I wasn't originally worried about at all! My boyfriend went in yesterday for the antibody test (negative) and got his blood drawn for PCR RNA too.
In SF they do give pcr rna tests.
In SF they do give pcr rna tests.
it sounds like a false positive case, oral sex then positive regardless of timeline is very very rare. of course giving the benefit of the doubt, of the pcr test.
i would imagine the counselor is somewhat knowledgeable, but doubt he knows much about false positives on pcr tests.
i would imagine the counselor is somewhat knowledgeable, but doubt he knows much about false positives on pcr tests.
Regarding the use of PCR's
The San Francisco City Clinic uses the new FDA approved Aptima PCR RNA as a standard diagnostic test as a matter of routine. They performed this test 12 days after my possible exposure (I went in for standartd STD Screening) - I did not request the test and was suprised they offered it. But it appears to be a routine part of the process perhaps because of the high specificity (low false positives) or maybe because of the clientele in this area supports the use of this test to curb the relatively high rates of HIV transmission.
The San Francisco City Clinic uses the new FDA approved Aptima PCR RNA as a standard diagnostic test as a matter of routine. They performed this test 12 days after my possible exposure (I went in for standartd STD Screening) - I did not request the test and was suprised they offered it. But it appears to be a routine part of the process perhaps because of the high specificity (low false positives) or maybe because of the clientele in this area supports the use of this test to curb the relatively high rates of HIV transmission.
Xhost,
I should have put that as letter (C)
(C) No "city-ran" clinic would do a PCR by RNA for an "oral" risk. Xhost is indeed right. Any truely knowledgeable HIV counselor, at least one who was legitimate and competent, would NEVER have recommended a PCR test for an "oral" risk, nor an antibody test @ 2 weeks for such a low-risk exposure.
This element just heightens the inaccuracy of the original post.....at least to me.
Some other event/risk led you to believe you needed to be tested Justin.
I should have put that as letter (C)
(C) No "city-ran" clinic would do a PCR by RNA for an "oral" risk. Xhost is indeed right. Any truely knowledgeable HIV counselor, at least one who was legitimate and competent, would NEVER have recommended a PCR test for an "oral" risk, nor an antibody test @ 2 weeks for such a low-risk exposure.
This element just heightens the inaccuracy of the original post.....at least to me.
Some other event/risk led you to believe you needed to be tested Justin.
I am sure someone will correct me if I am wrong about any of the following, so here goes:
PCR/False Positive: Your counselor seems a bit, well, misinformed. I am not up on the most recent data for PCR tests, but I do know that in the past these tests returned an uncomfortably high number of false positive results. The reasons for this are varied, but the fact is that they did. Your counselor should have informed you of this risk when you took the test. And frankly, I am surprised that your counselor would even recommend such a test for oral sex, which is a low, low, low, low, low or no risk of HIV. Does the counselor work for a testing company? In any event, until you test positive on an antibody test, you are not considered HIV + anyway. The PCR test is NOT a standalone test, and requires confirmation with, I believe, a western blot test.
If the oral sex event is the only risk (or, in this case, non-risk) that you are worried about, it would seem to me that you are the victim of a false positive on the test. Again, I am not a doctor, but it seems highly unlikely that you contracted HIV from either receiving or performing oral sex.
The question, I suppose, is what to do now. Given the PCR test result, I am sure you are in a pretty dificult situation at this point. I do not envy you. But, the fact remains that you basically had no HIV risk from the oral sex incident that you described. Having said that, you will want to test again at the appropriate time, mainly to reassure yourself that you are indeed HIV negative (and if the oral sex was truly your only "risk", you will most assuredly continue to test negative on the antibody tests).
Also, if you have not already done so, you may want to consult with your doctor on this one, or some other professional who, perhaps, specializes in HIV. Not because you have it, but just to get a second opinion, and maybe some much needed professional advice/reassurance.
Call me crazy, but your story seems really wishy-washy to me.
Why?
Because ..
(A) No "city clinic" does PCR by RNA nor DNA. (too costly and they would never do it...unless you were at a MD office, and most of the time they wouldn't do it, due to the high false-positive rates)
(B) No HIV counselor, who was at least "somewhat" knowledgeable would give you an antibody test after 2 weeks, even they should be knowledgeable according to NYS Guidelines that this is TOO early for antibodies to be revealed and for many NYS ran-clinics it is primarily their statutes not to test anyone before three months.
Now,....tell the truth. What was the real risk?
Why?
Because ..
(A) No "city clinic" does PCR by RNA nor DNA. (too costly and they would never do it...unless you were at a MD office, and most of the time they wouldn't do it, due to the high false-positive rates)
(B) No HIV counselor, who was at least "somewhat" knowledgeable would give you an antibody test after 2 weeks, even they should be knowledgeable according to NYS Guidelines that this is TOO early for antibodies to be revealed and for many NYS ran-clinics it is primarily their statutes not to test anyone before three months.
Now,....tell the truth. What was the real risk?
I was warned about false positives with the RNA tests.
Just took mine last week and there is some information
out there on the possibility of false positives.
I think you will have to retest.
For some reason the word following "finger" was bleeped out -- anyways, the test involved drawing a small amount of blood from my finger.
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