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PCR bDNA value

Jan 26, 1999

Dear Dr Holodniy,

I did a PCR for HIV bDNA exactly one month after a high risk exposure to the HIV virus(receptive anal sex with HIV+ person). It came back negative (undetectable <500 copies/ml). I also did an ELISA at the same time (negative also). At the lab, a physician told me that I wasn't infected due to my negative result in the PCR. I'm just wondering if he isn't a bit irresponsible on saying this, considering that this result should always be followed by an ELISA at 3 and 6 months (as you stated in your previous answers). Is he speculating or there's some truth on what he said? I would appreciate a lot your opinion. Thanks.

Response from Dr. Holodniy

PCR and bDNA technologies are quite different, but measure the same thing, namely the HIV viral RNA in plasma. An ELISA could certainly be negative at one month, but a person still be infected. In all people that have been studied to date, viral load testing has been positive in people by one month after infection, if the date is accurately known. The two tests have additive predictive value. Viral load is not approved for HIV diagnosis, hence the recommendation of serial antibody testing for 6 months.


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