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Exact meaning of recent results of Ultra Sensitive RNA QN test?
Jun 15, 2014

I have reviewed your forum and did not find an exact answer to my question. From what I did learn in reviewing this subject, I find I am very fortunate in where my HIV viral load has been for several years, <20 copies/ml. However, in researching this test online, I can't find a test that measures <50 copies/ml. Can you explain exactly why my test results show <20 copies/ml?

Also, at the bottom of the lab result for this test, it states status as Negative. What exactly does this mean and what is the risk of transmission in performing oral sex if I have no lesions, etc., in my mouth?

Response from Dr. Holodniy

Over the last almost 20 years of HIV viral load measurement, we have seen multiple tests that were developed to measure viral load, and they all had different lower limits of detection (LLD). As the technology got better, the sensitivity of the assays improved and the LLD declined. Thus, we started with assays that had an LLD of 500, 400, 200, which then decreased to 75, 50, 40, and now 20 copies/mL. So yes, there were assays that did have an LLD of < 50 copies/mL. Although viral load results of < 20 copies/mL can indicate that viral load still exists below 20 copies, but can't be quantitated; it can also mean that viral load is not detectable at all in that particular assay. This does not mean that HIV is eradicated, as it still will exist in blood cells and other organs in a latent, nonreplicating state. Infectivity in bodily fluids is certainly reduced, but risk of transmission is not zero.



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