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Follow up: viral load measurement

Mar 6, 2005

Dear Mark: Thank you for the prompt reply to my previous query (attached below). The person in question is my nephew who most likely acquired the virus Korea. He tested positive via an HIV-1 test (confirmed with western blot). Now it turns out that this ID doctor also ordered a bDNA (undetectable). I have been on the internet and have ome across case reports that these assays sometimes have quantification issues with "foreign" subtypes, and there are some pretty exotic subtypes (even the B subtype is very different from the western B subtype) in Korea. Hence my concern. The undetectability is simply incompatible with his clinical symptoms and a declining cd4 count and %. for the past one year. Is it possible to take some other test, say the Gen-Probe TMA, which I have heard is more reliable than these 2? Who should I contact for this test?

Your advice will be extremely valuable for us. Many thanks.

Attached below is our previous correspondence:

Dear Mark: For a patient who has tested positive, but has an undetectable viral load via Amplicor 1.5 AND viral symptoms persisting with CD4 declining, would you recommend any other viral load assay? Would the bDNA be useful? If even that is undetectable then is there any there option for measuring the viral load? That is, is there a more accurate test than these 2?

Kindly let me know, and thanks for the awesome job n this forum. >>>>>>>>>>>>>>>>>>>>>>>>>>>> Always worth while trying another testing platform. It is unlikely that one is more "accurate" than another. >>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Response from Dr. Holodniy

In some of these cases you might try another assay. CD4 counts may be the only way to assess disease progression risk, need for treatment, and response to treatment.

consistent good labs without meds
Viral Load Pattern

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