The accuracy of PCR test, cocktail therapy & an HIV cure
May 29, 2012
Hi Dr Young, Thank you so much for your answer and it sets my mind at ease as I suffered from anxiety and depression in the past. The risky event almost triggered an anxiety attack. After taking a closer and comprehensive look at your impressive credentials, you are, in fact, one of the experts most eminently qualified to answer my questions. This time around, my questions for you are: 1)What is the statistical accucacy for the TWO PCR NAAT TEST results I got at 31 days and 55 days post exposure respectively (as I indicated in my first question to you?) Is the later PCR test (55 days post exposure) more accurate than the first (31 days post exposure)? 2)As you have mentioned that PCR test one month post exposure is a pretty darn good evidence that I don't have HIV..then why was it not approved as a conclusive diagnostic test for HIV treatment? Will PCR test be validated as a diagnostic test soon? 3)Should I get another PCR test along with the ELISA TEST you recommended to rule out COMPLETELY the existence of BOTH HIV ANTIBODIES and HIV virus in my bloodstream 3 MONTHS POST EXPOUSRE? If there is no antibody detectable via ELISA HIV TEST at that point(and that if I am tested NEGATIVE for ELISA TEST 3 months post exposure)..does it mean that HIV is not present in my bloodstream? 3)Since your answer did not directly address the POST EXPOSURE PROPHYLAXIS I have taken(COcktail therapy consisted of tenofovir, lamivudine and kaletra) for up to 3 days, do you mean that it will not delay the seroconversion process? I am concerned that the prophylaxis can lead to FALSE-NEGATIVE because I have read that COCKTAIL THERAPY taken as prophylaxis can delay the formation of HIV antibody, is it true? 4)Is a RAPID HIV TEST as conclusive and definitive as ELISA TEST 3 months post exposure? If not, how accurate is a rapid HIV test? I most likely will get a RAPID TEST 3 months post exposure at around June 27 to avoid the uncertainty and anxiety of waiting for ELISA test result (my risky event is dated March 19)..what's the statistics on a rapid HIV test taken 3 months post exposure? 4)Can the aforementioned 2-3 days cocktail therapy sufficient enough to kill any HIV virus before it invades the immune cells by hijacking CCR5-delta to replicate rapidly? 5)I have read the March 2012 issue of Scientific American about the blocking of HIV attack using gene-editing by disabling CCR5-delta...does it mean a cure for HIV and AIDS are imminent or foreseeable within the next 3 to 5 years with reasonable certainty? It'll be an honor to meet you in person.Will you by any chance might be visiting Vancouver,Canada? I live in Vancouver, Canada and I have been told by American tourists that Vancouver reminded them ofColorado in its stunning snow-covered mountain and natural beauty.
Response from Dr. Young
Hi and thanks for posting again. I appreciate your comments about Vancouver and Colorado- I've been to your lovely city and surrounding mountains several times and have had a terrific time (Todd Bertuzzi not withstanding).
Let me see if I can answer your questions: 1) I'm afraid that there's no way to answer this question with any precision. It's just not the way that the scientific studies were performed; yes, a PCR done later is generally more sensitive than one done earlier. But recall, that even a negative PCR isn't proof that HIV isn't there- there are those very elite controllers who are HIV infected but (off medications) don't have detectable virus in their blood. 2) I don't believe that the PCR test will ever be approved as a formal test for HIV diagnosis. 3) Three days of antiretroviral therapy will not have any effect on the sensitivity of antibody testing for HIV. For that matter, three days of treatment isn't likely to be an effective PEP treatment anyways. 4) HIV rapid tests are ELISA-based. A rapid test at three months is generally taken as a statement of being HIV negative. 5) The CCR5 strategy has indeed generated a lot of interest (read up on the "Berlin patient"), but it is a very, very long way from this becoming a routine way to treat (or ahem) cure HIV. Thanks for your kind words.
Be well, be safe. BY
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