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Follow-up-quantification error

Mar 20, 2005

Dear Dr.

The initial RNA PCR viral load was 19200 and dropped to <50 in 3 months (no meds)-infection 4.5 years old (initial VL 1800, rising steadily every year since then).

Test done through Quest-blood drawn early morning at hospital and picked up soon after by Quest-I'm located very close to them. But there may have been a delay in sending the specimin this time around and hence the concern.

Thank you and God bless.

Here is the original question and your response:

Dear Mark,

I got an unexpectadly low result on my viral load this month (I will spare you the background details). Now, I am concerned because it normally, if I take the test Monday morning, I get my results Tuesday evening. But this time, I got them back Wednesday evening. Is it possible that the lab didn't freeze the sample and kept it at room temperature so the stability of the sample was compromised? How long can it stay stable at room temperature-50-60 hours?

Please let me know soon because I am very worried.

>>>>>>>>>>>>>>>>>>>>>>>>>>>> You don't indicate what your previous viral load was and what it dropped to. That is pretty quick turnaround for viral load testing. Most people won't even get them back within the week. It is unlikely the lab did not process or freeze the sample appropriately. I would just wait and see what the repeat result is.

Response from Dr. Holodniy

A change from 19,200 to < 50 copies/mL is indeed too much to be accounted for by any routine assay variability and looks much morelike someone who just started treatment. Hard to know what might have accounted for this change. Although samples are supposed to be frozen within 6-8 hours after collection, even if the blood was held out at room temperature overnight and then processed, this kind of change would not be seen. I would just have it repeated.

cd4 counts and vl
Just a thank you

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