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Had Protected Anal Sex. HIV RNA And DNA PCR Test Done. What Does The Value Signify? Am I HIV Negative?

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Posted on Thu, 23 Aug 2012
Question: I had an anal sex with condom, but first I didn't use condom just i put my penis in one's anus and did not insert it. then I used condom. the relation was mutual we both used condom. then I went to test. my HIV 1/2 antibody test after one week was non reactive and they referred me to HIV RNA and DNA PCR test. I did it after 19 days of exposure, it is <75 copies/ml and <1.88 log cps/ ml respectively. the normal range is also this. Am I HIV negative.? what is this copies per ml ?the virus DNA/ RNA or the blood antibody DNA / RNA which work against the virus?. I am very concerned , please help me. If it is the virus DNA or RNA it means I have the virus? I don't have any other disease except I am a little obsessive and have anxiety sometimes. Thanks
doctor
Answered by Dr. P V S Prasad (5 hours later)
Hello
thanks for posting your query.
your situation is you tested for antibody and it is negative in one week.This is expected because antibody will take 3 months to become positive. this is infact called as the window period.
Hence they asked for more blood tests. One of them is HIV RNA. This is the test usually done in the early incubation period. This is to detect the number of viral copies. This test detects plasma HIV 1 RNA by reverse transcription-polymerase chain (RT PCR). This test could have false positive report. hence it is used as a supplementation in anti body negative acute infection. hence this was done in your case. the problem now is it is positive but at low levels. Copies /ml denote the number of viruses. it is considered low especially if it is less than 1000 copies/ml. Now you have to be confirmed by another test. Hence they have done DNA PCR.

DNA PCR has few advantages. One is that it can be reported faster than culture which takes 2-4 weeks. but dis advantage is that there is a risk of false positive reactivity due to contamination of specimens. similarly fasle negatives also can occur.It was concluded that it is not sufficiently accurate, to be used for the diagnosis of HIV infection without confirmation.
TO conclude , the situation is that the tests are positive but in the normal range. these tests are done to detect the virus particles only. the interpretation is very difficult in situation like yours basically when there is risk of infection in the form of penile or anal contact.
Hence only anti body tests should be done at three months or should be supplemented by CD4 assays to know if treatment should be started.
Hence the best advice is to consult your Sexually transmitted disease specialist to clarify your doubts.

Ref:Clinical laboratory diagnosis of HIV-1 and use of viral RNA to monitor infection. King Homes Third edition P976.
Prasad PVS
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. P V S Prasad

Dermatologist

Practicing since :1980

Answered : 254 Questions

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Had Protected Anal Sex. HIV RNA And DNA PCR Test Done. What Does The Value Signify? Am I HIV Negative?

Hello
thanks for posting your query.
your situation is you tested for antibody and it is negative in one week.This is expected because antibody will take 3 months to become positive. this is infact called as the window period.
Hence they asked for more blood tests. One of them is HIV RNA. This is the test usually done in the early incubation period. This is to detect the number of viral copies. This test detects plasma HIV 1 RNA by reverse transcription-polymerase chain (RT PCR). This test could have false positive report. hence it is used as a supplementation in anti body negative acute infection. hence this was done in your case. the problem now is it is positive but at low levels. Copies /ml denote the number of viruses. it is considered low especially if it is less than 1000 copies/ml. Now you have to be confirmed by another test. Hence they have done DNA PCR.

DNA PCR has few advantages. One is that it can be reported faster than culture which takes 2-4 weeks. but dis advantage is that there is a risk of false positive reactivity due to contamination of specimens. similarly fasle negatives also can occur.It was concluded that it is not sufficiently accurate, to be used for the diagnosis of HIV infection without confirmation.
TO conclude , the situation is that the tests are positive but in the normal range. these tests are done to detect the virus particles only. the interpretation is very difficult in situation like yours basically when there is risk of infection in the form of penile or anal contact.
Hence only anti body tests should be done at three months or should be supplemented by CD4 assays to know if treatment should be started.
Hence the best advice is to consult your Sexually transmitted disease specialist to clarify your doubts.

Ref:Clinical laboratory diagnosis of HIV-1 and use of viral RNA to monitor infection. King Homes Third edition P976.
Prasad PVS