Dear Dr. Holodniy, There is so much information available about the "correct" use of viral load tests out there...and so much of it is contradictory!! Dr. Anthony Fauci stated at Geneva that early detection and treatment (pre-seroconversion) of HIV infection might enable one to salvage enough of the immune system to effecetively win a chronic fight with the virus. Therefore it would seem that bDNA and PCR tests should be encouraged for high risk groups (after all, these tests are used for diagnostic purposes with newborns). Yet the CDC still refuses to endorse these tests as valid screening devices or even to discuss their use at all on their national hotline! So I'm hoping you can answer my questions. Assuming that the lab technicians are competent and the tests are performed correctly: 1) When are bDNA and QHIV - 1 DNA by PCR tests as accurate as a 6 month antibody test? 2) Is there a closing of the window on these tests (ie. will these tests show positive for a while then return to negative at a certain point after infection?) 3) Is one viral load or PCR test a better diagnostic tool than another during the pre-seroconversion stage? 4) What is a fair price to have a viral load test? Thank you for your help.

Great questions, all of them. Taking 1 and 2 together, viral load and cellular DNA PCR tests will be positive within several days to a couple of weeks after infection. Antibody tests will lag behind by 4-12 weeks. At 6 months after infection, all 3 tests will be positive. DNA PCR and Plasma viral load (using either bDNA or PCR)will be positive throughout infection. Question 3. From my experience and the limited published data, I don't think that one viral load test is better than another during preseroconversion. they are measuring the same thing. Question 4. Street price for viral load testing varies around the country. Range is about $150-250/test. MH