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RNA accuracy if not a false positive...
Jun 4, 2010

Hi Bob, I have tremendous respect for the work you do and the honest appraisal you give to all questions. My question is more scientific than anything else. Assuming a high risk encounter(unprotected intercourse w/ unknown status). I'm fairly certain that the antibody test is widely considered the "gold standard" for detecting HIV. However, the FDA approved accute RNA test is offered in certain NYC clinics as a side by side with rapid 1/2 test. I'm well aware that this is not a stand alone diagnostic test. And after following these boards and checking some archives I see that you frown upon the RNA test due to high cost and false positive rate amongst some other factors. However, putting aside cost , with there remaining a small percentage of people who don't seroconvert by 6 months, does a negative RNA test run alongside a negative antibody test provide a more conclusive result? I apologize if this has been asked. The only info I find discusses high cost and false positives. Just curious if a negative result side by side with a neg antibody 3 and 6 out is more encouraging than just antibody test or if it's a waste of time. Thanks in advance, I'm more than happy to donate to your efforts.

Response from Dr. Frascino

Hi,

You are correct: An HIV-antibody test outside the window period remains the gold standard and best diagnostic test for HIV. FDA-approved HIV RNA tests can be helpful in some situations, particularly diagnosing HIV disease in the window period for folks with a significant exposure risk and symptoms consistent with acute retroviral syndrome (ARS). As to whether there is any benefit to running RNA tests outside the window period along with HIV antibody tests for diagnostic purposes, we do not know, although data is being collected. Chances are the extremely high costs, potential for false-positive results and other technical concerns will limit any significant potential benefits.

Thank you for supporting The Robert James Frascino AIDS Foundation (www.concertedeffort.org). In return I'm sending you my good-luck karma that you are now and will always be HIV free!

Be well! Good luck!

Dr. Bob



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