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relationship between viral load and antibodies in diagnostics

Feb 24, 2002

Dr Little---

I understand that PCR is not a tool recommended for diagnosis of HIV. However, in the absence of antibodies (due to possible simultaneous co-infection) six months from exposure, would a quant PCR detect HIV down to 50 copies? Trying to uderstand the dynamic: In an immunoincompetent host (due to simultaneous co-infection), if the antibody period is delayed, what does viral load do? If the body is not making antibodies, would the viral load stay low, as it is not being challenged/not in competition? Or would viral load soar as there is no challenge and virus just replicates with abandon? Maybe it's not as simple as that, but any insights you can give would be most appreciated. Thanks for yor expertise and compassion.

Response from Dr. Little

If I understand your question correctly, you are asking if an HIV RNA PCR test done 6 months after HIV and Hepatitis C coinfection would detect HIV - YES, this is a very good test and while coinfection may delay the development of an HIV antibody test result, the HIV RNA PCR test is so sensitive, that I do not believe that this test would be negative after 6 months of HIV infection.

Just to clarify though, the HIV RNA PCR test can be negative in people who are HIV positive - this occurs when the viral load in the infected person is below the limit of detection (a good thing) presumably because of a good immune response. This is why we always pair HIV RNA PCR and HIV antibody tests.

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