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gold standard ?
Oct 5, 1998

Why are all these people with negative antibody tests having very expensive Viral load tests performed? Or did I just answer my own question?$$$$$$$$$$$$$$$$$$$$. I thought negative Elisas at 6months were enough to rule out HIV regardless of the exposure. Are MD.s rethinking this or is this still the same proceedure? If you saw a patient what would you request to rule out infection?

Response from Dr. Holodniy

The standard algorithm is still in place. Viral load is not an FDA approved test for the diagnosis of HIV infection. However viral load has found some useful nitches in the diagnosis of HIV infection(i.e. neonatal infection, where maternal antibodies may cause a false positive in the baby for months; repeated indeterminate western blots; some situations with source patients of health care worker needle stick exposures; in patients with signs and symptoms consistent with acute retroviral syndrome in whom HIV antibody tests are negative to name a few). I have in fact used viral load for diagnosis in few situations like those I outlined above. MH



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