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Testing after high risk exposure
Aug 15, 2006

How long following a high risk exposure should it take for HIV and HCV to show up on RNA PCR tests, generally speaking. I will be following up with antibody tests at a later date.

Response from Dr. Daar

Most people will have HIV and HCV RNA detected in their blood within 2-4 weeks of an exposure that results in infection. However, it is important to note that this is not always the case and follow-up testing is necessary even if these tests are negative. It is also important to note that false positive results can occur with these assays. It is for these reasons that RNA testing is generally not recommended for use as a diagnostic test after an exposure, particularly for HIV. The exception might be in antibody negative individuals with symptoms of acute or primary HIV infection where viral loads are very high (usually greater than 100,000 copies/mL) and easy to distinguish from false positive results where they are generally less than 1000 copies/mL.

For all of these reasons I would encourage anyone who has had a potential exposure to undergo antibody testing and would discourage the use of virologic tests such as those for RNA using PCR assays. You can only imagine how much anxiety is caused by a false positive test.

Best, Eric


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