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RNA NAAT Testing
Is HIV after 4 weeks - 6 months when the viral load is not at its highest (because it is past acute phase) still detected by NAAT testing?
Best Answer
The PCR test you are referring to after 28 days is a DNA PCR test and not NAAT which seeks out the HIV RNA sooner, a window of 12 days.
So the question still remains. Will a NAAT test pick up if a person is HIV +/- after the acute phase is well over (around one month to 6 months)?
HIV RNA is highest during the acute phase (2-4 weeks after infection) but the levels are suppose to come down for months or years when HIV is dormant in the body. Will NAAT detect HIV at these low levels?
So the question still remains. Will a NAAT test pick up if a person is HIV +/- after the acute phase is well over (around one month to 6 months)?
HIV RNA is highest during the acute phase (2-4 weeks after infection) but the levels are suppose to come down for months or years when HIV is dormant in the body. Will NAAT detect HIV at these low levels?
This is what I was told
Edward W Hook, MD, Aug 28, 2010 07:37AM
Welcome back to the Forum. as you know, Dr. Handsfield and I share the forum. You got me as is appropriate given our interchange earlier this month and my resulting familiarity with your situation. FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.
As for your question, the answer is that, in the absence of taking anti-HIV medications, the combination of a negative antibody test and a negative PCR at 28 days following a potential exposure is definitive evidence that you do not have HIV. Parenthetically I would add that you could get the same level of assurance from a negative DUO (combination p24 antigen/HIV antibody) test more inexpensively. When there is a discrepancy between symptoms and tests, the tests are ALWAYS correct. The symptoms of HIV that you had mentioned in earlier posts are non-specific. In contract the test results are highly standardized and perform with great precision. You do not have HIV. EWH
Edward W Hook, MD, Aug 28, 2010 07:37AM
Welcome back to the Forum. as you know, Dr. Handsfield and I share the forum. You got me as is appropriate given our interchange earlier this month and my resulting familiarity with your situation. FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.
As for your question, the answer is that, in the absence of taking anti-HIV medications, the combination of a negative antibody test and a negative PCR at 28 days following a potential exposure is definitive evidence that you do not have HIV. Parenthetically I would add that you could get the same level of assurance from a negative DUO (combination p24 antigen/HIV antibody) test more inexpensively. When there is a discrepancy between symptoms and tests, the tests are ALWAYS correct. The symptoms of HIV that you had mentioned in earlier posts are non-specific. In contract the test results are highly standardized and perform with great precision. You do not have HIV. EWH
The viral load is the highest within the 1st handful of week after infection and then drops. The antibodies are always produced and most people would produce them at 4 weeks. So this is why we recommend a antibody test at 3 months.
But is NAAT sensitive enough to detect virus after 3 months of infection when, from what I understand, the virus goes into a latent phase?
While it is a reliable test an antibody test is still the test that should be taken at 3 months post exposure.
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