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resubmitted, HIV-1 RNA at 899 copies
Apr 15, 2006

Hello Doc , I recenlty had a exposure of receving oral sex from sex worker . 4 week oraquck was negative , and had hiv1-rna pcr which they say priliminary test has 899 copies. I want to know is this really true and wat are the false positive with this test , Can a normal cold i had could affect this test ?, I am about to break down . thanks and keep up the good work. I have donated previoulsy and will do so in future.

Response from Dr. Frascino

Hello,

First a couple of facts:

1. Oral sex carries an extremely low risk for HIV transmission.

2. HIV-antibody tests taken prior to three months from the time of potential exposure are not considered definitive or conclusive, and are therefore not recommended.

3. HIV PCR RNA tests are not recommended for routine HIV screening due to the rate of false-positives (2% to 9%) and cost.

4. A "normal cold" would not affect HIV-antibody test results.

With these facts in mind, you should, at this point, be able to realize several things:

1. Your HIV risk is minimal.

2. Your four-week OraQuick test is not definitive.

3. Your HIV PCR RNA should not have been done.

By following the rather straightforward guidelines for HIV testing, all of your worry could have been avoided. Your current dilemma is exactly what I try to caution people about when they begin freaking out after a minimal to no-risk exposure and then immediately run out and get inappropriate HIV tests. (I hope those reading this forum will take note of this gentleman's very avoidable problem and not make the same mistakes!)

OK sir, I'll step off my soapbox now and get back to your question. As I mentioned, your HIV risk is extremely low at best. Your four-week negative OraQuick is encouraging, but not definitive. Your HIV-1 RNA PCR is most likely a false-positive. False-positive tests occur in 2% to 9% of folks without HIV infection, virtually always with low HIV RNA titers (less than 10,000 c/ml) like yours. People experiencing acute retroviral syndrome prior to seroconversion generally have HIV RNA levels that are extremely elevated, usually in the 100,000 to 1,000,000 c/ml range. My advice to you is to stop worrying and follow the HIV testing guidelines. That means get an HIV-antibody test at the three-month mark. By all indications it will be negative.

Good luck!

Dr. Bob



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