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HIV-PCR Qn, <40 & "0"

Feb 5, 2005

First of all, thanks to each and every one of you doing this work at The Body. It is excellent! And I continue to learn so much from you.

My question concerns the viral load test "HIV-PCR quant". My doctor (who is well-known and well respected in this area), or perhaps more accurately the lab he uses, has changed from one kind of HIV-VL test to another, to this "HIV-PCR quant." test.

According to my doctor the difference between this test and the one we had been using before is: a) this new test ("PCR") can test down to 40 (instead of 50 previously), b) "PCR" can tell if there are viral copies *under* 40 or not and thus c) apparently can say if there are "0" HIV copies.

I've been on meds since April 2003 with much success. My last labs before the test change were all "<50". I've had four tests since the change and they have been: "<40" (but with virus), "0", "45" and "0". At the last doctor's appointment my doctor assured me that "0" meant "0".

I live in Germany, but I receive "The Body" newsletters regularly (and I ALWAYS read them!) and I *never* see people talking about these kinds of labs. So I thought maybe you could shed some light on this for me. (Do we have better tests here in Europe? If so, why? Is my doctor giving me inaccurate interpretations of the lab results? If so, why? And what would be accurate, etc.)

Please don't misunderstand me: if I really only have "0", then I'm VERY happy about it. I just don't understand why you (at The Body, whom I trust) never mention numbers (and concerns) like these.

Thank you very much for any and all information.

"Happy to be a Null, but wondering if's True"

Response from Dr. Holodniy

I don't know what assay he is referring to. There are certainly NO approved viral load assays in the US that can make a claim of detecting down to zero. There are certain techniques (more plasma, spinning the sample very hard to pellet all the virus, more amplification or PCR, etc) that can improve the sensitivity of these assays. These procedures also create more variability in the number that is obtained at these very low levels. Regardless of what these plasma viral loads measure down to, there are still HIV infected cells circulating in the blood and many infected cells in lymph nodes and other tissues.

viral load
what to ask in lab results

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