Question for Dr HHH,

I just want to have a clarification on the HIV NAT test and looking for a blog like answer for someone who’s trying to know more about this test and it’s purpose. 

1. I did a 4th generation test ( hiv 1 and 2 antibody + p24 antigen ) at 9 months and at 12 months post potential exposure( for mental reassurance). I wanted to know : Is a HIV NAT test required to confirm that I don’t have HIV ?

2. Is the NAT test the same as HIV PCR, RNA viral load ? Why do they change name.

Thank you

NAAT stands for nucleic acid amplification test.  NAAT tests can test for different nucleic acids (RNA or DNA) and go by a variety of names reflecting the chemistry used in the test.  PCR tests are one type of NAAT. All NAATs test for viral nucleic acid by chemically causing targeted RNA or DNA  from HIV to reproduce itself, amplifying the amount of nucleic acid present and making it easier to detect.  NAAT tests are more sensitive than tests for antibodies which take weeks to develop. They are also more sensitive than tests for viral protein (p24 antigen) because of the amplification process.  As more sensitive tests NAATs become positive before antigens or antibodies from the virus can be detected.  

NAAT tests can be configured to be quantitative and in persons on HIV therapy are used to monitor the effectiveness of treatment (with effective treatment the amount of viral RNA circulating in an infected person is lowered, ultimately becoming undetectable with effective therapy).  Thus NAAT tests can be used both for diagnosis (detection of new infections) or to monitor therapy (when they are used to measure the amount of virus present [viral load}.

Bottom line- you have conclusive tests.  You do not need more tests of any sort.  You do not have HIV.  EWH

EWH