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DNA PCR vs. RNA PCR in HIV+ people
Nov 29, 1999

1. If I tested positive on ELISA and undetectable on viral load (RNA PCR till 15 copies) would DNA PCR tell me, how many of my cells are infected per mililiter or only confirm the infection. Because I thought that the DNA PCR also says how many cells are infected per mililiter just like the RNA PCR. 2. Is Roche the only company that has the only manufacturer for this test? 3. Is DNA PCR FDA approved and RNA PCR isn't and what is the reason for that? 4. Is DNA PCR more reliable in diagnosis and why? 5. Some Doctors claim that DNA PCR has more false positives in people with a negative staus, than RNA PCR what is the reason for that ? 6. Is it because the test is run many times and the microscope has to be thouroughly cleaned every time?

Response from Dr. Holodniy

1. Confirm infection. 2. Yes, in terms of commercially available kits, although many labs might use a "home brew" (separately purchased reagents possibly from different vendors). 3. HIV RNA PCR is approved for following treatment and assessing prognosis. Qualitative HIV DNA PCR is approved for diagnosis. 4. HIV RNA PCR is not approved for diagnosis. DNA PCR might get a few more true positives in the very small group who are antibody positive, RNA negative. However, I am always worried that antibody positive and RNA negative people, in the absence of therapy, might be the result of a non type B strain that the current RNA PCR test might be able to detect or quantitate correctly. A bDNA viral load test might actually confirm a much higher viral load. 5. Not sure about your #5. I am not aware of any rigorous studies comparing the false positive rates of RNA and DNA in seronegatives. 6. No microscope is used. Although it may be a contamination issue in the PCR machine. MH



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