hiv dna pcr

The dr told me to wait 8 weeks. Said I was low risk but how relissble is going in 4 weeks or doing dna by pcr

[jhguy011]

No test is conclusive before 3 months (if you had a risk, that is).

[cna341]

you can do a DUO test 4weeks(28days) post exposure which is less expensive and will be a good indicator of your status,

[jhguy011]

Again, no test is FDA approved to be conclusive until 3 months post-exposure.  

[micheal021]

They don't offer duo in united states. Closet is dna by pcr

[Teak]

Wrong. They do offer DUO tests in the US and the are FDA approved. PCR-DNA tests are not approved.

[micheal021]

Where do I get duo test done at and how long does it take for results

[cna341]

DUO test has been approved by FDA recently.and are available in some labs.i didnt say conclusive but it is at least 99% accurate at that point(data published by manufacturers and also has been confirmed by all of the doctors on this website).                                             only a 3 month test will be 100%conclusive.

[Teak]

Do you even need testing? You said low risk, what was your exposure?

[micheal021]

Was with a girl with no condom for about a minute.  Dr hook said its low exposure. What do u think I running around like I have it. Soooo scared

[Teak]

You wouldn't be the first. You can test as advised 3 months post exposure to obtain a conclusive test result.

[micheal021]

Is that really considered low risk

[Teak]

A risk is a risk.

[mememe2010947]

If it's past 4 weeks, and you have access to PCR and want it, then get it in combination with an antibody test. That combination should be a very reliable predictor of the result when you do a repeat antibody test past 3 months.

There's usually proviral in DNA PCR, viral in RNA PCR, or antibody in response to the infection. Very few people (~1%) have undetectable virus (in PCRs with < 50 copies) who are infected and not taking medication, and that is usually a good predictor of long term non-progression. But that's usually after antibodies have been produced to control the infection.

If you're sick and have undetectable viral load, then it's most likely not because of HIV.

[mememe2010947]

I mean if you're sick at 4 weeks during the window period and have undetectable viral load, then it's most likely not because of HIV.

[Teak]

No that is not true at all.

[safeeuroguy]

Just visited with my Dr (who is an HIV/infectious disease specialist).  He said in his 15 years of experience, an RNA viral load test would be very high and detectable 2 to 4 weeks after exposure.  He runs it with an antibody test.  Stated that false positives are a reality with RNA (although getting more rare) but not a false negative.

But hey, what does he know? He has only had 1000's of patients.

[Teak]

1. The discussion was PCR-DNA testing. The test is not approved to diagnose HIV.
2. PCR-RNA test are supplemental tests that have to be used in conjuction with an antibody tes.

[expendable]

PCR tests are not recommended because of high rate of false positives /and they are incredibly expensive/

But in my opinion there is no chance to have false negative PCR RNA test 3-4 weeks after initial infection. RNA test can detect less than 100 copies of virus in blood.

Could you imagine a person with acute infection, not on PEP to has undetectable viral load?

It is impossible!

On the other hand, Teak is right in his replies above.

[Teak]

People that have had an exposure with an HIV positive person and on nPEP wouldn't have an acute infection if the medication worked nor would they have a viral load.

[expendable]

Yes, I agree with with you. I wrote:

"Could you imagine a person with acute infection, not on PEP to has undetectable viral load?

It is impossible! "

If you are not on PEP, you would have acute infection /with symptoms or asymptomatic, doesn´t matter/ and you would have detectable viral load

michael021 was not on PEP

[Teak]

Well that isn't true either at 3-4 week people may not have a high enough VL for the test to detect. It may be months or years as with LTNP and elite controllers.

[expendable]

Wow, this is a new information for me. Thank you Teak. So, this is the reason why these PCR test are not recommended for primal screening purposes?

[Teak]

Correct.

[safeeuroguy]

About 1 in 100 people living with HIV are LTNP and 1 in 300 are elite controllers.  Teak is correct in that the elite controllers keep viral load less than 50 copies but would product antibodies.

[Teak]

Reason PCR-DNA tests are not approved for HIV diagnoses.

[mememe2010947]

The majority of long term nonprogressors (LTNP) and elite controllers (ECs) still go through an initial high viral load (VL), at least in the hundreds of copies. But they have a peak viral load that is much lower, compared to non LTNPs. This is prior to producing antibodies and eventually reaching a set point of undetectable/low VL several months later.  

So an RNA PCR (< 50 copies) should still detect the viral load for the vast majority of LTNPs past 4 weeks DURING THE WINDOW PERIOD. An undetectable viral load with no antibodies detected beyond 4 weeks is a very good predictor that an infection did not happen (since UD VL happens only to very few people), although repeat antibody testing is needed past 3 months.

Cases do exist where ECs/LTNPs who have undetectable viral load before seroconversion and after 4 weeks, and ECs/LTNPs who have prolonged seroconversion, but these cases get published in journals because this is even more unusual than being an EC/LTNP.

Anyway, DNA PCR is not widely used, and is mainly meant for babies born from HIV positive mothers. But it is a very useful tool to show whether or not HIV is present when combined with an antibody test, regardless of whether or not it's FDA approved for diagnosis. Basically, past 4 weeks, if you have a positive viral load from an RNA test, then you HAVE to have a positive in the DNA test. But if you have a positive in the DNA test, then you may not have a positive in the RNA test (if you are an EC/LNTP, or if you are taking medication). If you plan to do DNA PCR, you might as well request a CBC differential with it.

If you have DNA PCR available, then you should also have RNA PCR available, because it's more widely used, and RNA will tell you the quantity of virus detected, while DNA will only tell you if it's detected or not. DNA is slightly less sensitive and looks for HIV in a different part of your blood, but it is still very, very sensitive, and so it is a very good tool to predict the antibody test outcome past 3 months, even though it's not an approved diagnostic test.

[micheal021]

So I checked everywhere in Arizona no duo testing.  All labs are saying Dna by pcr is good and 99.9 afte 3 weeks. And dr hook said that my chances are like less than one in a million.  I'm so confused. What test should I have its been 5 days and waiting for 8 weeks seems like eternity. I appreciate all ur help. Thanks a lot.

[mememe2010947]

Duo just got FDA approval in 2010, so you probably won't see it widely available in the US for several more years, as clinics phase out antibody-only tests. Even though duo makes the time to test positive a few weeks shorter than antibody-only testing, it will still miss about 5-10% of positive cases during the early period. So repeat antibody testing is still recommended later. And duo is still less sensitive/accurate than RNA PCR (at least the ultrasensitive PCRs), but it is cheaper and a faster turnaround time for results.  

If you are set on taking a PCR past 4 weeks, either DNA or RNA + antibody should give you a very reliable predictor for a repeat antibody past 3 months.

Think of it this way: a blood bank screens donor blood for HIV with RNA RT PCR + antibody. And it doesn't wait for the donor to confirm 3 months waiting period before saying the blood is negative for HIV. Also, the number of transfusion transmissions has decreased dramatically from this sort of screening, even though the total number of HIV positive cases have gone up. So this combination is very reliable, although not 100% effective. The cases that blood banks miss are donor blood who recently got infected, like less than 2 weeks, when RNA and antibody aren't detectable; and the rare individuals whose cases get published in journals.

[mememe2010947]

And, BTW, whoever is reading this, please be safe, and remind others involved with you to be safe, for the sake of themselves and others. HIV is still a non-curable disease, even though medication has helped prolong many lives.

[Teak]

You can tell me about LTNP when you've been one and you know what you are talking about.

[mememe2010947]

Oh, as an FYI, Oraquick Advance is in its final stages before FDA approval for home use, and clearance will probably happen sometime late this year. So if it gets FDA approval (probably will), then you should see it available at a local drugstore by 2012 for about $25. This is good because about 20-25% of people don't know they are infected, and clinics aren't everywhere. So having this on the market should help with better distribution and testing awareness.

[mememe2010947]

Please don't tell me that only LTNPs have knowledge about LTNP clinical staging of HIV progression.

[Teak]

There again you talking BS. MOVE along.

[micheal021]

Have a question y would dr hook say chances are less than 1 in a million if no condom on while having vaginal intercourse

[Healthadvisory]

Hiv is very difficult to get.

most people dont have hiv.

[Teak]

You play Russian Roulette? I know people that were infected on their very first exposure.

[nomore11]

I was under the same impression that most dont have it, always used protection. However the 1 night i was drunk led to unprotected sex. My friend was with me at the time and i asked him to let me burrow a condom since i happen to be unprepared at time. however, he forgot,  as we kept drinking one thing led to another and i end up with the  with the girl having unprotected vaginal sex. This is my only time i have taken such risk. However,  couple weeks later i got symptoms similar to ARS. Now im feeling like hell. although, i have negative test just 30 days im feeling test will eventually be postive because experianced most  symptoms including night sweats and oral thrush, which i know would be a stong indicator. Now im waiting in misery for 2nd month. I which there was more ads like anti tobacco about this scary disease because much is not done about keep everyone aware. as much sex is promoted i think this could be saving lifes.