[Question #4704] HIV Testing Nomenclature Confusion

28 months ago
Drs,

Apologies if this is a basic question, but I'm confused by HIV testing nomenclature. 68 days after an exposure, I had the following test from LabCorp:

RNA, Real Time PCR (Graph)
HIV-1 RNA by PCR

Results stated "<20 copies/mL, HIV-1 RNA not detected"

I believe this is considered a NAT or NAAT test and so therefore should be well outside the testing window. Is this accurate? Can I accept this to mean that conclusively I am negative?

Much thanks.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
Welcome to the forum.

Yes, that's a nucleic acid amplification test (NAAT or NAT). It's negative:  almost all HIV infected persons have >20 copies of the virus per ml of blood, so less than 20 is the same as zero.

Rare HIV infected persons are "elite controllers", i.e. their immune system keeps the virus in check and they may therefore have negative NAAT results. For assurance you are not infected, you also need an HIV antibody test (or antigen-antibody, AgAb, "duo" test) at least 4 weeks after the last possible exposure, if not already done. If not already done, look for such a test at LabCorp. But in the meantime, don't worry:  the NAAT alone is nearly conclusive and it is extremely unlikely you have HIV.

If you'd like to provide some information about the exposure you are concerned about, I may be able to give more specific advice on all this. In the meantime, I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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28 months ago
Thank you Doctor. I also had a 4th gen w Rfx test on day 30 and day 44 that were both non-reactive. In reading other posts, my exposure was what you would consider low, or even theoretical risk. It's embarrassing but it was a brief handjob from a stripper in NYC, and some of her vaginal secretions got onto my penis including the head. I'm guessing she was 25-30 years old and from Cuba. All things considered, would you consider the risk to be theoretical at worst and the results to be 100% conclusively negative? Especially since I've been tested three different times and with two different tests.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
Thanks for the follow-up information. I'm glad you had the additional testing. I agree there was no more than a theoretical chance you caught HIV from the exposure described, since there has never been aknown case of transmission by hand-genital contact, even if genital fluids were used as lubricant. Also HIV is in excellent control in Cuba, so your partner's nationality doesn't concern me. In any case, even if you had had a substantial exposure, your test results are 100% conclusive. You can move on with no worries of HIV.---
27 months ago
Thank you Dr. Handsfield. One final question before the thread closes: Would daily usage of Lisinopril or Citalopram, and occasional usage of Alprazolam, have any effect on testing? Would it delay timing in receiving a positive result? I believe in other threads you've mentioned no known medications have an effect on HIV testing.

Thank you again for all of your responses.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
The statements you found in other threads remain correct. There are no medications of any kind that interfere with HIV tests or change the reliability of the results. (With the earliest HIV antibody tests, there was concern about this problem for chemotherapy, certain immune suppressive drugs, and a few others. Even these were rare, if they occurred at all -- but for the newer (4th generation) HIV tests, there is no problem even with these drugs. Certainly the commonly used drugs you mention have no effect.

That concludes the two follow-up replies included with each question and so ends this thread. I hope the discussion has been helpful. Spread the word about the forum!
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