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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