please answer (RNA PCR versus DNA PCR 2009)
Dec 14, 2009
dear doc bob i had a risky hiv incounter from oral sex with a csw and drug abuser wich landed me with genital herpes 2 weeks later i started experincing a mono like illness so i went and had a 3 month antibody test wich came back negative symptoms still persisted for months later so i went back and had a complete std screen at 9 months wich also turned out negative except for the herpes so my doc refferd me to a i.d specalist who did a hiv rna quanative with a hiv 1/2 ab test he also did a cbc with differintal and a hep panel and ebv panel.the hiv rna was undetectable down to 48 copies and everything else was negative except for the ebv wich reads (ebv)vca ab (igg)3.77 ebv (ebna)ab,igg 5.00 and ebv ab,vca (igm)0.90 in range.interpatation says suggestive of a past infection but doc says that it looks like i'm just getting over mono.so i asked him to do a hiv dna pcr and he stated that a dna would never show posotive over a rna and that the rna was the gold standard to pcr testing.but i know that the viral load test is not a diagnostic test and the only pcr test for diagnostic purpose is the hiv rna qualative test by abott.can you please shed some light on my situation from your expertise on my assesment.will donate
Response from Dr. Frascino
The sensitivity and specificity of HIV PCR DNA (qualitative) and HIV RNA PCR (quantitative) test are similar, although studies indicate that the HIV DNA PCR might have the slightest edge in sensitivity. (DNA PCR sensitivity is greater than 99% while RNA PCR sensitivity can range from 95% to 98%). I tend to use these two tests for different purposes. The HIV PCR RNA is used primarily to quantify HIV replication while the HIV PCR DNA is used to help sort out unclear or indeterminate HIV-antibody test results. Neither HIV DNA PCR nor HIV PCR RNA is recommended for routine HIV diagnostic screening. The best test for HIV diagnostic screening remains the HIV-antibody test taken outside the window period.
Thanks for your desire to make a tax-deductible donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. In return, I'm sending you my good-luck karma that your definitive and conclusive HIV tests remain negative.
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