HIV RNA Test Accuracy

HIV RNA Test Accuracy: How Accurate are the HIV RNA Tests

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If you think you’ve been exposed to the HIV virus, conditions are good for infection, or you are/were in a high risk situation where your partner was infected, many doctors recommend the HIV RNA early detection testing. Unlike other tests that measure the body's response to the virus, an attempt at combating it, HIV RNA early detection tests measure the actual virus in the body itself- before the body has a chance to react.

  • Viral load is usually high enough 9-11 days after exposure for a positive result.

Though there are benefits for early detection, allowing access to earlier health care, HIV RNA tests carry a higher risk for false positive results. It’s also possible to be HIV positive but have a viral load level too low to be detectable with an HIV RNA test, but that often means the patient is already on antiretroviral therapy. Fortunately, any physician monitoring the situation will be able to discern the difference, since the patient is already being treated.

  • RNA tests are more often used to monitor the progression of HIV, measuring the viral load in the body, as opposed to simply detecting HIV in the way antibody tests do.
  • The testing window available, though earlier than any other test, is shorter.
  • False positives are more common in RNA tests than other HIV tests, but easy to identify, requiring subsequent testing.
  • HIV RNA tests are also frequently used to screen blood donations for infection.

How HIV RNA Early Detection Tests Work

In order to identify infection, RNA (genetic material of HIV virus) levels are measured in the bloodstream. In the case of an infected patient, RNA levels get pretty high during the primary (acute) infection stage, often above 100,000 copies per ml. vs. the normal 5,000 copies per ml.

False Positives

Unfortunately, false positives are more common than other forms of HIV testing, which is one reason why HIV RNA testing isn’t commonly used like antibody testing is. However, a false positive result is very easy for a physician to identify. Testing resulting in a positive read, but offering a very low viral load (which is conflicting) will be re-tested for confirmation.

False Negatives

False negative results occur most commonly early on/ soon after initial exposure, before the recommended testing windows for each individual test. It is possible for viral load to be too low for HIV RNA testing to pick up on at this point, prior to 9-11 days. If you are using an antibody/antigen testing process before the body has had an opportunity to react to the virus and manufacture antibodies, a false negative would result.

How Accurate is the HIV RNA testing Process?

HIV RNA tests are claimed to be 90% accurate 10-12 days after initial exposure. Although this is vastly more accurate than anything else at this point, Antibody/antigen testing is claimed to show a 99.97% accuracy rate. However, Antibody testing can’t be used at this early stage.

The HIV RNA test shows a 99% accuracy rate 12 weeks after exposure, although other tests will likely be used at this stage.

When Can the HIV RNA Test be Used?

Anyone who thinks they may have been exposed to the HIV virus through unprotected sexual activity, contact with blood that is infected, an infected mother who is pregnant/breastfeeding/ caring for her newborn, or someone who has shared dirty/non-sterile needles are some who can/would enjoy the benefits of early HIV detection.

  • Possible HIV-1 exposure in past twelve weeks
  • Those who’ve gotten positive results from HIV antibody testing
  • Children born to mothers who are HIV positive
  • HIV RNA tests are most often recommended around 9-11 days after infection!

Questions & Answers

Why should you choose the HIV RNA test instead of others?

The HIV RNA test is usually recommended for patients who have good reason to think they are infected, or those who were in high risk situations (for example, a medical caretaker coming into direct contact with infected blood). It isn’t commonly used in every case because it is both less accurate and more costly than other methods.

However, the HIV RNA testing process is the earliest method of detection available on the market today, offering the earliest possible access to medical care and antiretroviral therapy if needed.

What does RNA mean?

RNA stands for ‘ribonucleic acid’, and is the genetic material the HIV virus is made of. The HIV RNA early detection test specifically looks for this type of RNA in the body.

What are some early symptoms of HIV I should watch out for, which might mean I have the virus?

Some of the more common early onset symptoms of HIV include sore throat, skin rashes, intense headaches, fevers and swollen lymph nodes. These are just some of the common symptoms, but not all.

These symptoms don’t mean you absolutely have the HIV virus. Instead, they should be discussed with your primary care provider/physician, in order to determine exactly why they are present.

If I’m losing 9.1% in accuracy, why use the HIV RNA early detection test at all?

The earlier you know for sure whether or not you’ve been infected with HIV, the earlier you have access to advanced antiretroviral therapy, and the better your chances to not only keep viral load low, but stop it from increasing altogether! When it comes to HIV, the last thing you want to do is ignore the problem. Like so many other things, the virus is 100% guaranteed to get worse. Unlike most other medical conditions, there is yet no absolute cure for HIV, so stopping the spread early is the best we can hope for.

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