Nov 14, 2006
If someone's viral load is undetactable, does it mean that the results for HIV test would be negative? Or does it still show positive? Thanks.
Response from Dr. Sullivan
There are several tests that are used for detection of HIV. the most commonly used test is one that measures HIV antibodies. Individuals who become HIV infected begin making antibodies to many different parts of the virus within a few weeks of being infected. These antibodies are present for the lifetime of the individual with rare exceptions. The antibody test uses a screening ELISA assay which will identify all who are positive and some who are negative, if positive this is followed by a western blot assay which confirms the presence of antibodies specific for parts of HIV. In the developing world 2 different ELISA assays are used instead of the western blot which is expensive and cumbersome. The diagnosis of HIV can also be made by detection of HIV nucleic acids, either RNA or DNA. HIV - DNA is present inside HIV infected cells and an individual who has been infected with HIV will always have detectable HIV- DNA, even when HIV- RNA is not detectable. HIV-RNA is a measure of the viral load and represents replicating virus. HIV-RNA becomes detectable within the first week following infection. The goal of therapy with combination antiretroviral therapy is to drive the viral load[HIV-RNA] to undetectable levels[ less than 500 or less than 50 copies of RNA in one milliter of blood, depending on the sensitivity of the assay[ a milliliter is 1/5th of a teaspoon]. HIV - DNA remains detectable even when HIV- RNA / viral load is undetectable. Both HIV -RNA and HIV- DNA are detectable in HIV infected infants and can be used for rapid diagnosis before maternal antibodies have disappeared. JLS.
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