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What Do These Following HIV Test Reports Indicate?
Question: Dear Dr,
I am male 29 yrs old who is living in East XXXXXXX I had an possible hiv exposure 18 months before,I have been taken so many hiv tests in East XXXXXXX in different intervals,all came back negative results.
But few months before I visited XXXXXXX I took few HIV tests in metropolis lab(14 months after exposure),all results are clear and understandable, But my HIV-1 Rna pcr qualitative result came back ‘Not detectable’ in interpretation part mentioned ‘not detectable’ result indicates absence of HIV-1 infection or individual with less than 20copies/ml.
I attached my reports for your review, Please note this attached tests I took 14 months after exposure in XXXXXXX
Kindly clarify below,
1.Please go through my HIV-1 RNA PCR qualitative report – What does my ‘not detectable’ result indicates whether Positive or Negative ?
2.I see many other labs are mentioning the word ‘Not detected’ for HIV-1 Rna pcr qualitative result,but my reports says ‘Not detectable’, there is any difference between this two words when it comes as a result of 'NOT DETECTABLE' and the result of 'NOT DETECTED'?
3.As you know in XXXXXXX most(more than 98%) prevalent HIV -1 virus is C subtype from M group strain, but here in east XXXXXXX most prevalent HIV-1 virus are A,B,C and D subtypes from M group strain,I see in XXXXXXX few HIV test kits (J XXXXXXX & Co and others) detecting only antibodies for HIV-1 ‘C’ subtype of M group and O group strains, it does not detect other subtypes (A,B,D,E,F,G,H,I,K) of M group strain, Pls can you tell me my tests HIV DUO by CMIA & western blot hiv 1&2, these two tests whether they have covered HIV-1 antibodies for all subtypes (A-K) from M group strain?
4.Also my HIV-1 RNA PCR qualitative test whether it has covered all subtypes (A-K) of M group strain?
5.after that exposure immediately within eight hours I took PEP hiv drugs for 5 days then I stopped due to side effects, there is any chance this 5 days PEP affected my HIV tests which I took 14 months after exposure?
6. One year after exposure I tested two times my CD4 and CD8 count without doctor advice, results as below,
First time:
cd4-726
cd8-703
cd4/cd8 ratio-1.03
Second time after 3 weeks gap,
cd4-975
cd8-901
cd4/cd8 ratio-1.08
Why my Cd4/Cd8 ratio is near to one? is it normal ratio?
5.I have few symptoms from that incident like white coating on tongue with bitter taste and seborrheic type of rashes on my back comes and goes, with all these test result what is your opinion on my hiv status ?Do I need to repeat hiv tests in future without new exposure?
Thank you
I am male 29 yrs old who is living in East XXXXXXX I had an possible hiv exposure 18 months before,I have been taken so many hiv tests in East XXXXXXX in different intervals,all came back negative results.
But few months before I visited XXXXXXX I took few HIV tests in metropolis lab(14 months after exposure),all results are clear and understandable, But my HIV-1 Rna pcr qualitative result came back ‘Not detectable’ in interpretation part mentioned ‘not detectable’ result indicates absence of HIV-1 infection or individual with less than 20copies/ml.
I attached my reports for your review, Please note this attached tests I took 14 months after exposure in XXXXXXX
Kindly clarify below,
1.Please go through my HIV-1 RNA PCR qualitative report – What does my ‘not detectable’ result indicates whether Positive or Negative ?
2.I see many other labs are mentioning the word ‘Not detected’ for HIV-1 Rna pcr qualitative result,but my reports says ‘Not detectable’, there is any difference between this two words when it comes as a result of 'NOT DETECTABLE' and the result of 'NOT DETECTED'?
3.As you know in XXXXXXX most(more than 98%) prevalent HIV -1 virus is C subtype from M group strain, but here in east XXXXXXX most prevalent HIV-1 virus are A,B,C and D subtypes from M group strain,I see in XXXXXXX few HIV test kits (J XXXXXXX & Co and others) detecting only antibodies for HIV-1 ‘C’ subtype of M group and O group strains, it does not detect other subtypes (A,B,D,E,F,G,H,I,K) of M group strain, Pls can you tell me my tests HIV DUO by CMIA & western blot hiv 1&2, these two tests whether they have covered HIV-1 antibodies for all subtypes (A-K) from M group strain?
4.Also my HIV-1 RNA PCR qualitative test whether it has covered all subtypes (A-K) of M group strain?
5.after that exposure immediately within eight hours I took PEP hiv drugs for 5 days then I stopped due to side effects, there is any chance this 5 days PEP affected my HIV tests which I took 14 months after exposure?
6. One year after exposure I tested two times my CD4 and CD8 count without doctor advice, results as below,
First time:
cd4-726
cd8-703
cd4/cd8 ratio-1.03
Second time after 3 weeks gap,
cd4-975
cd8-901
cd4/cd8 ratio-1.08
Why my Cd4/Cd8 ratio is near to one? is it normal ratio?
5.I have few symptoms from that incident like white coating on tongue with bitter taste and seborrheic type of rashes on my back comes and goes, with all these test result what is your opinion on my hiv status ?Do I need to repeat hiv tests in future without new exposure?
Thank you
Brief Answer:
You are safe
Detailed Answer:
Hello. Thank you for writing to me.
1. Hiv PCR RNA not detectable means you are negative specially considering that your other tests for Hiv i.e Hiv antigen and antibody based tests are negative. Not detected Hiv 1 PCR RNA can also occur in Hiv ppostive patients who are on ART but this is not the case with you
2. No detected and Not detectable are essentially the same
3. Most modern tests are able to pick all types and forms of Hiv therefore Hiv DUO and western blot tests that you did and came negative should have reliably covered all groups and subtypes of Hiv.
4. PEP can delay seronconversion but 14 months is long enough for an individuals to seroconvert even if he took PEP.
5. Normal CD 4/ CD 8 ratio is between 1-2.
6. White coating on tongue and seborrheic dermatitis are not specific for Hiv and can happen otherwise as well. Since you have been reliably ruled as Hiv negative by multiple tests therefore I don't think there is need for further testing.
Regards
You are safe
Detailed Answer:
Hello. Thank you for writing to me.
1. Hiv PCR RNA not detectable means you are negative specially considering that your other tests for Hiv i.e Hiv antigen and antibody based tests are negative. Not detected Hiv 1 PCR RNA can also occur in Hiv ppostive patients who are on ART but this is not the case with you
2. No detected and Not detectable are essentially the same
3. Most modern tests are able to pick all types and forms of Hiv therefore Hiv DUO and western blot tests that you did and came negative should have reliably covered all groups and subtypes of Hiv.
4. PEP can delay seronconversion but 14 months is long enough for an individuals to seroconvert even if he took PEP.
5. Normal CD 4/ CD 8 ratio is between 1-2.
6. White coating on tongue and seborrheic dermatitis are not specific for Hiv and can happen otherwise as well. Since you have been reliably ruled as Hiv negative by multiple tests therefore I don't think there is need for further testing.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Dear Doctor,Thanks for your answers.
1.Your answer seems both words 'Not detectable' and 'Not detected' means the same thing,i.e my 'Not detectable' result indicates that HIV-1 PCR assay has not detected viral copies up to its limit(20copies),am I right?
2.What is the difference between qualitative and quantitative HIV-1 PCR RNA test,I see in both tests they have mentioned detection limit is 20 copies.in that case how these two tests can be differ?
3.as you have gone through my report ,In my PCR HIV-1 RNA qualitative test it has mentioned there detection limit is 20copies ,it means that assay whether can it detects only up to 20 copies or even less that? I am asking this question because i see now few PCR assays detects even less than 20copies qualitatively(virus present or not).
4.Please find attached pictures,as I told you from last 13months i have this rashes on my back which comes and goes,mostly burning and slightly itchy,if you look my pictures carefully you can see few big rashes in first two attachments,normally this rashes are burning.I took below treatment for this rashes,but no improvements i see.Please advice your opinion on my rashes and treatment.
1. Taken Fluconozole 150mg-3 weeks + applied antifungal cream
2. Taken Itraconozole -2weeks + applied antifungal cream
During my XXXXXXX trip Dr said its acne,he prescribed below medicines for two months,completed one month before but still symptoms present.
3.Doxiem(Doxycycline hyclate),
Allerpar(chlorpheniramine malete,calcium gluonate with vitamin C)
Biona-E(Biotin,N-acetyl cysteine,vitamin and minerals)
Clindamycin phosphate topical solution applying on body
most of the times when i start to eat I can feel that burning sensation on my rashes.
Thank you doctor.
1.Your answer seems both words 'Not detectable' and 'Not detected' means the same thing,i.e my 'Not detectable' result indicates that HIV-1 PCR assay has not detected viral copies up to its limit(20copies),am I right?
2.What is the difference between qualitative and quantitative HIV-1 PCR RNA test,I see in both tests they have mentioned detection limit is 20 copies.in that case how these two tests can be differ?
3.as you have gone through my report ,In my PCR HIV-1 RNA qualitative test it has mentioned there detection limit is 20copies ,it means that assay whether can it detects only up to 20 copies or even less that? I am asking this question because i see now few PCR assays detects even less than 20copies qualitatively(virus present or not).
4.Please find attached pictures,as I told you from last 13months i have this rashes on my back which comes and goes,mostly burning and slightly itchy,if you look my pictures carefully you can see few big rashes in first two attachments,normally this rashes are burning.I took below treatment for this rashes,but no improvements i see.Please advice your opinion on my rashes and treatment.
1. Taken Fluconozole 150mg-3 weeks + applied antifungal cream
2. Taken Itraconozole -2weeks + applied antifungal cream
During my XXXXXXX trip Dr said its acne,he prescribed below medicines for two months,completed one month before but still symptoms present.
3.Doxiem(Doxycycline hyclate),
Allerpar(chlorpheniramine malete,calcium gluonate with vitamin C)
Biona-E(Biotin,N-acetyl cysteine,vitamin and minerals)
Clindamycin phosphate topical solution applying on body
most of the times when i start to eat I can feel that burning sensation on my rashes.
Thank you doctor.
Brief Answer:
Answers to specific queries
Detailed Answer:
Hi.
1. Yes, you are right.
2. Qualitative PCR tests for whether any viral RNA is present, whereas quantitative PCR tests for the amount of viral RNA present.
3. Detection limit up to 20 copies/ml means that it cannot detect lesser than that RNA copies e.g it cannot detect 5 copies/ ml. However, even if a test detects 20 copies/ ml it is considered to be very sensitive and reliable.
4. I have reviewed the attachments. Yes, these raised bumps/ pimples on back are acne. I suggest you to use either benzoyl peroxide gel, twice daily or benzoyl peroxide body wash. I think they would improve on this treatment. In my view benzoyl peroxide would be much more effective than clindamycin. In addition you may continue with doxycycline 100 mg twice daily.
Regards
Answers to specific queries
Detailed Answer:
Hi.
1. Yes, you are right.
2. Qualitative PCR tests for whether any viral RNA is present, whereas quantitative PCR tests for the amount of viral RNA present.
3. Detection limit up to 20 copies/ml means that it cannot detect lesser than that RNA copies e.g it cannot detect 5 copies/ ml. However, even if a test detects 20 copies/ ml it is considered to be very sensitive and reliable.
4. I have reviewed the attachments. Yes, these raised bumps/ pimples on back are acne. I suggest you to use either benzoyl peroxide gel, twice daily or benzoyl peroxide body wash. I think they would improve on this treatment. In my view benzoyl peroxide would be much more effective than clindamycin. In addition you may continue with doxycycline 100 mg twice daily.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr,thanks for your answers,
1.is it hiv-1 pcr qualitative test more accurate than pcr quantitative test interms of detection limits?
2.If I take a child who not exposed to hiv to metroplois lab for hiv-1 pcr qualitative test ,the same report would be given which i got 'Not detectable'?because i am worrying about this world 'not detectable' instead of 'not detected'.
3.I see and read some reports, now few quantitative hiv-1 pcr rna assay even detects less than 20 copies/ml qualitatively(virus present or not)but cannot quantify less than 20copies,so we see some reports '<20 copies' which means HIV-1 RNA detected but below the lower limit of linear range of the assay. it means that particular assay has ability to detect even less than 20copies?
4.In my case during my XXXXXXX trip i did two PCR RNA tests as below,
(a)after 14 months exposure from metropolis lab XXXXXXX -HIV-1 PCR RNA qualitative test-my result was 'NOT DETECTABLE' ,in interpretation part mentioned this test report indicates absence of hiv-1 infection or individual with viral copies less than 20copies/ml.
(b) after 15 months exposure from Dr lal path lab- HIV-1 RNA PCR quantitative test,my result was 'Target not detected' in interpretation part mentioned sample provided does not contain hiv-1 RNA.
with this result of 'Not detectable' PCR RNA qualitative test and result of 'Target not detected' PCR RNA quantitative report Please can you conclusively say both reports indicates hiv-1 negative result?
5.I am recently married 4 months before,I am planning for a baby, with my all test reports (hiv duo,western blot,hiv-1 pc rna qualitative &qauntitative)as a doctor please can you tell me without hiv fear can i plan for a baby?
5.there is any chance my hiv test result will change in future without any further exposure?
6.am i conclusively hiv negative?do i need to repeat any hiv tests in future without further exposure?
Please note that my all stds (syphlis,HBV,HCV,HSV1&2) reports are negative after 14 months of exposure
Thank you
1.is it hiv-1 pcr qualitative test more accurate than pcr quantitative test interms of detection limits?
2.If I take a child who not exposed to hiv to metroplois lab for hiv-1 pcr qualitative test ,the same report would be given which i got 'Not detectable'?because i am worrying about this world 'not detectable' instead of 'not detected'.
3.I see and read some reports, now few quantitative hiv-1 pcr rna assay even detects less than 20 copies/ml qualitatively(virus present or not)but cannot quantify less than 20copies,so we see some reports '<20 copies' which means HIV-1 RNA detected but below the lower limit of linear range of the assay. it means that particular assay has ability to detect even less than 20copies?
4.In my case during my XXXXXXX trip i did two PCR RNA tests as below,
(a)after 14 months exposure from metropolis lab XXXXXXX -HIV-1 PCR RNA qualitative test-my result was 'NOT DETECTABLE' ,in interpretation part mentioned this test report indicates absence of hiv-1 infection or individual with viral copies less than 20copies/ml.
(b) after 15 months exposure from Dr lal path lab- HIV-1 RNA PCR quantitative test,my result was 'Target not detected' in interpretation part mentioned sample provided does not contain hiv-1 RNA.
with this result of 'Not detectable' PCR RNA qualitative test and result of 'Target not detected' PCR RNA quantitative report Please can you conclusively say both reports indicates hiv-1 negative result?
5.I am recently married 4 months before,I am planning for a baby, with my all test reports (hiv duo,western blot,hiv-1 pc rna qualitative &qauntitative)as a doctor please can you tell me without hiv fear can i plan for a baby?
5.there is any chance my hiv test result will change in future without any further exposure?
6.am i conclusively hiv negative?do i need to repeat any hiv tests in future without further exposure?
Please note that my all stds (syphlis,HBV,HCV,HSV1&2) reports are negative after 14 months of exposure
Thank you
Brief Answer:
No need to worry and no need for further tests.
Detailed Answer:
Hi.
I will answer your last question first. There is no need for any further tests and all your tests results for STDs are final and conclusive. They wont change anytime in future. You can plan for a baby. This is how the rna pcr test is reported in all i.e detectable or not detectable or not detected (means the same thing) and depends on the sensitivity of test i.e ability to detect the defined minimum limit of rna copies/ml with a test is defined as the sensitivity of a particular test. The lower the defined minimum number of rna copies detecable by a test, higher the sensitvity. Moreover dr.lal and metropolis labs are reliable labs and therefore results are accurate and dependable.
Regards
No need to worry and no need for further tests.
Detailed Answer:
Hi.
I will answer your last question first. There is no need for any further tests and all your tests results for STDs are final and conclusive. They wont change anytime in future. You can plan for a baby. This is how the rna pcr test is reported in all i.e detectable or not detectable or not detected (means the same thing) and depends on the sensitivity of test i.e ability to detect the defined minimum limit of rna copies/ml with a test is defined as the sensitivity of a particular test. The lower the defined minimum number of rna copies detecable by a test, higher the sensitvity. Moreover dr.lal and metropolis labs are reliable labs and therefore results are accurate and dependable.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr,
Thanks for your answers,I understood below from your answers,Please confirm below whether i am correctly understood?
1.Your answer seems generally all HIV-1 PCR RNA qualitative/quantitative tests are reported detectable/ detected (both means the same thing) or Not detectable/Not detected (both means the same thing),am I right?
2.If someone receives hiv-1 rna pcr result of not detectable/not detected result for diagnostic purpose ,it indicates negative,am I right?
3.Finally after 19 months exposure i took a hiv rapid test in east XXXXXXX result came back negative,as my so many hiv tests(rapid,elisa,p24,pcr) are negative in last 19 months from exposure do you think there is any minimum chance of my negative hiv staus will change in future without further exposure?
Thank you for your time .
Thanks for your answers,I understood below from your answers,Please confirm below whether i am correctly understood?
1.Your answer seems generally all HIV-1 PCR RNA qualitative/quantitative tests are reported detectable/ detected (both means the same thing) or Not detectable/Not detected (both means the same thing),am I right?
2.If someone receives hiv-1 rna pcr result of not detectable/not detected result for diagnostic purpose ,it indicates negative,am I right?
3.Finally after 19 months exposure i took a hiv rapid test in east XXXXXXX result came back negative,as my so many hiv tests(rapid,elisa,p24,pcr) are negative in last 19 months from exposure do you think there is any minimum chance of my negative hiv staus will change in future without further exposure?
Thank you for your time .
Brief Answer:
You dont have Hiv
Detailed Answer:
Hi.
1. Yes
2. Yes
3. No
Regards
You dont have Hiv
Detailed Answer:
Hi.
1. Yes
2. Yes
3. No
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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