[Question #7526] Elite Controller- Ultra Sensitive hiv testing

4 months ago
Hello doctors thank you for your time

. I believe I am an elite controller and my body is suppressing the virus to undetectable levels as a result I’m showing negative on 4th gen antibody testing and pcr RNA testing almost a year after exposure. 

In my search for more sensitive testing I came across a blood donor panel testing available at many different labs. This test will clear people that are donating blood, tissues, organs etc of many infectious diseases  I called the lab and they said that they their screening is more sensitive than what is available such as 4th gen hiv antibody and  hiv PCR RNA .  Blood donor panel screening is not intended for diagnostic purposes but will definitely let you know if you have an issue.  

  Doctors I wanted your opinion as to if you thought the blood donor panel testing was more sensitive than the assays available through our doctors or hospital etc. And if a person truly thought they were infected with hiv should they opt for the blood donor panel testing at lab corp  or quest . It seems like a no brainer  to me to be 100 percent confident that you are not infected.

Thank you 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
4 months ago
Welcome. Thanks for your confidence in our services.

I'm afraid you misunderstand some basic issues about HIV infection and elite controllers. Such lucky persons are easily diagnosed:  elite control means non-progression of immune deficiency and, in most such persons, undetectable virus in the blood with PCR (RNA) viral load testing. Because the viral load usually is undetectable, they cannot infect their sex partners. However, the standard diagnostic tests -- especially antibody tests -- are positive. Your negative AgAb (4th generation) test conclusively shows you do not have HIV.

You're not alone in your misunderstanding of these issues. There have been a number of questions like yours over the years -- all of them with the same misunderstanding, i.e. not being aware that the antibody tests are positive and the standard diagnostic tests relible. The only difference is in progression of immune deficiency.

To my knowledge, the standard blood donor testing panel uses the same PCR technology as standard testing used to meauure viral load and follow HIV infected persons, assessing their responses to treatment.

You don't say exactly how long it is since your most recent possible exposure to HIV. But if it was more than a few weeks after AgAb testing, you can be sure you don't have HIV.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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