Before i start i would just like to say what a great job you guys do - very inspiring!
I am after some clarification on the use the HIV and Hepatitis C RNA PCR Detection test that you and other centers are currently using. I have recently had this test and it came back as 'non reactive' but i am just a bit unsure on one or two things. The doctor that i saw was very helpful and advised my risk was low, even though my concern was around un protected sex with a british woman on and off with over a series years. we went with the above test based on the last exposure (test was done 13 days post potential exposure) and i was advised on receipt of the results that i did not need any follow up and that this test was enough given the circumstances. i have since spoken to another doctor who has advised similar and said that in life there bigger things to worry about!
whilst i am not overly concerned could you help with the following:
- Is this test ok as a diagnostic test? (presume it is given lost of centers are offering it)
- Would this test pick up any infection that I may have had prior to last exposure (eg so if i got HIV infected 4 years ago but only tested now would this test detect the RNA still and be valid)?
- do i really need another test? (i undertsand this was the general advice at the time of the test being released but due to improvements and results this is no longer neccesary.- both doctors i have spoken to have said not to waste my time or money!)
i know the blood service use this test because of its ability to detect things early but confused over whether it can only be used for early diagnosis or if it can be used at any time after 10 days to 1000 days!
HIV testing has evolved so much over the 30 years of the epidemic that the original tests now seem so very poor.
You've given some explanation of your circumstances but you haven't explained why you wanted to have an HIV test in the first place, given that you have been sexually active with this lady for a number of years. This is important because the testing "context" is important to offering the correct test for the individual.
In your circumstance I personally probably would have offered an HIV DUO and an HIV RNA PCR primarily to reassure you about the distant past because people do have some difficulty conceptualising the newer tests.
With reference to your specific questions:-
Quote:
- Is this test ok as a diagnostic test? (presume it is given lost of centers are offering it) yes, it is. as I mention above, HIV testing in 2011 is very different to HIV testing in 1983. The New York HIV /AIDS institute offers something similar as an HIV 1 RNA PCR at 7 days along with an antibody test. You have had the luxury of being able to pay for a thoroughly expensive, state of the art HIV test. Public health laboratories and testing centres have different constraints and will not typically offer this test.
- Would this test pick up any infection that I may have had prior to last exposure (eg so if i got HIV infected 4 years ago but only tested now would this test detect the RNA still and be valid)?it will reliably identify any infection provided you are 1) not being actively treated for HIV at the time of testing or 2) one of very very few "elite" controllers who are HIV infected individuals who manage without treatment to control their HIV viral load to undetectable levels. These individuals are rare - very rare
- do i really need another test? (i undertsand this was the general advice at the time of the test being released but due to improvements and results this is no longer neccesary.- both doctors i have spoken to have said not to waste my time or money!) I think I would agree with the other doctors - you will have spent a considerable amount already - I don't think a further test would add to your knowledge. It might make you more comfortable. Beyond that, because I don't know the exact circumstance I wouldn't comment further except to say that if you have a nagging doubt then have another test for peace of mind.
i know the blood service use this test because of its ability to detect things early but confused over whether it can only be used for early diagnosis or if it can be used at any time after 10 days to 1000 days!Provided you do not fall into one of the categories identified above - ie treated HIV positive or elite controller then the test will identify you irrelevant as to the possible infective date. You should note though that the blood and organ transplantation service use both PCR and antibody testing.
RNA test calrification
Linear Mode
