[Question #14054] Labcorp RNA Test
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1 months ago
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Hello doctors and thanks again for your service, second time visitor. I’m hoping to avoid unnecessary testing so I wanted to confirm the updated guidance on HIV RNA tests I’ve seen on the forum.
Would test “139825 HIV-1/HIV-2 Qualitative RNA” be conclusive for a negative result at 12 days post exposure, regardless of exposure type? Or would a follow up 4th gen test be required for confirmation?
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H. Hunter Handsfield, MD
1 months ago
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Welcome back to the forum. Thanks for your continued confidence in our forum.
We have no way to monitor the performance of tests by particular labs. However, the standard HIV RNA PCR test, which undoubtedly is what Labcorp provides, is well documented to detect all HIV infections in persons tested 11 days or more after exposure. Some providers do follow-up antibody or AgAb testing a few weeks later, but that's primarily for patient reassurance, not because of actual medical need. You would do it if you like, but our advice is that it isn't necessary. There has been no change in this judgment or advice he past several years.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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1 months ago
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Thanks that’s very helpful and in line with what I’ve seen in your comments. As you know it can be hard to determine when researching online. I guess if there is anything publicly available that points to 11 days being able to detect all infections that would be helpful to see. If nothing like that exists I understand and will heed your advice regardless.
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H. Hunter Handsfield, MD
1 months ago
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My only additional comment is a response to "hard to determine when researching online." It really isn't so hard if you limit your searching -- whether on HIV or any other health problem that concerns you -- to professional or professionally moderated sites (health departments, academia, medical centers, and forums like this one). Especially avoid sites by and for people with the problem you're concerned about or at risk for it -- like some Reddit discussions, for example. Anybody can write whatever they want, and such sites always have perspectives from people who are intentionally misleading or seriously misinformed, including not really understanding how they themselves were infected.
Closing question about reliability of RNA testing at 11 days: try various academic and public health sites, including CDC. (CDC has been dangerously undercut by current political issues, but as best I can tell its' HIV/STI knowledge and advice remain reliable. You can also see other countries' national health sites, WHO, and so on.
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1 months ago
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Makes sense and please don’t take my comment as a complaint. It’s just that when the CDC says “A NAT can usually detect HIV 10 to 33 days after exposure” that may not help as much as it could if the true answer is closer to “11 days will detect almost all”.
Thanks again.
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H. Hunter Handsfield, MD
1 months ago
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Actually a good point about CDC: some would say there's a long history of a legally driven CYA attitude that works its way into some CDC advice (but not usually all of it). Perhaps that's the case here. You also could ask Labcorp directly. It's definitely in commercial labs' interests to provide scientifically accurate information about the tests they offer.---
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1 months ago
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Will do (and will follow up if I hear back). In the meantime I will operate under your guidance of 11 days being conclusive as that certainly seems to be a reasonable consensus. Thanks.
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1 months ago
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It doesn’t appear there is anywhere for a patient to direct this type of inquiry, only for providers. It’s no problem your reassurance is enough to move on, much appreciated.
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H. Hunter Handsfield, MD
1 months ago
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I'm glad to have helped. Take care and stay safe.
That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.
