Can alcohol affect the HIV DNA PCR test accuracy?

Hi doctor,

I have read that drinking alcohol affects the HIV (human immunodeficiency virus) test results. Does increased alcohol intake delay seroconversion time? If so, then how long one should wait, three or six months?

For such cases, can we take HIV DNA PCR (Human Immunodeficiency Virus Deoxyribonucleic acid Polymerase Chain Reaction) as a screening test? Whether this test is also affected by more alcohol intake or not. How reliable is this test?

I had oral sex around three years back, and I consume 150 ml of alcohol regularly. I had also taken the tablet Fluvoxamine 100 mg twice daily around five years back. I also got tested six times for a fourth-generation HIV test and once for a DNA PCR test from renowned laboratories,but all results were negative.

All the tests were also taken beyond the window period. For such a person, which HIV screening is recommended? For late seroconversion, which test is taken to find out HIV infection? Please explain in detail, as I am obsessed with HIV.

Thanks.

Hi doctor,

As per my knowledge, for late seroconversion cases, the virus antigen shall be formed but since antibodies are not produced, the level of antigen shall not reduce and will remain high.

It means even after six months, the delayed seroconversion cases will show the antigen as positive and the antibody as negative in the HIV Ab/Ag test report.

Please clarify this.

Hi doctor,

There is a suspected case of HIV infection with a coinfection of HCV (Hepatitis C virus) so seroconversion is likely to take around more than a year. It is also stated that the results of the p24 antigen are not very accurate.

Therefore, how such cases are diagnosed for HIV infection, whether fourth-generation HIV is taken or HIV DNA PCR, and why.

Please clarify.

Hi doctor,

Since I have read about HIV many times so my queries may be theoretical and I want answers to particular queries only to convince myself.

My specific question is: If seroconversion time is more than a year then what result will be shown in the fourth generation HIV test? If a person is HIV infected and he has no symptoms and he takes HIV DNA PCR (qualitative) test at 3 years period, what shall be the result?

Please clarify my specific queries for academic interest.

Thanks.

Hi doctor,

I am having one stressful question. I had a low-risk activity of deep kissing around two months back with my girlfriend. Around one month back, my wife took a diabetes test with a glucometer at a doctor's clinic, where it was known that the doctor did not change the pricking needle of the previous patient and had used the same needle on my wife. This scared us.

After this, I had unprotected sex with my wife three or four times. Now my worry is if we both take the HIV test after the window period of three months in each case, then whether cross-interaction of the HIV virus (if we both become infected) will make our results indeterminate.

Please clarify whether, in this situation, the HIV test results will be accurate or not after the three-month window period, or whether there will be any effect of cross-interaction of the HIV virus strains in infected cases.

Thanks.

Hi doctor,

Please clarify why the highly renowned laboratories take only the HIV-1 DNA PCR test and not the HIV-2 DNA PCR test.

Can you please explain why so?

Hi doctor,

I am talking to you after a long time.

I want to know that if in a doubt, a person takes HIV-1 or HIV-2 RNA PCR qualitative test in a renowned laboratory which has a detection limit of 20 copies/ml in HIV-1 RNA test and sensitivity limit of 100 IU/ml in HIV-2 RNA PCR test and, the result is declared as not detected in both tests.

Now, being a case of OCD he thinks that he may be under the limit of detection or sensitivity and so the results may not be showing as detected. The exposure period had already crossed more than six months, at this stage what tests should be done HIV duo or HIV-1 or HIV-2 rapid test.

Please suggest so that his doubt of being under the limit of detection or sensitivity of RNA PCR tests is resolved. Also, suggest whether the HIV duo test covers both HIV-1 and HIV-2 antibodies and is it reliable? How reliable is a rapid test at six months window period at a renowned laboratory?

The sensitivity limits of the RNA PCR test are the same in all standard laboratories for a qualitative test or not because only a few laboratories are doing HIV2 RNA PCR tests. Please also give data in percentages of HIV-2 cases to total HIV cases in India. Please give a point-wise detailed reply.

Thank you.

Hi doctor,

I could not get a specific answer to my previous query. If a person is in a serious confusion stage because he thinks that he has got cut off values in HIV-1 or HIV-2 RNA PCR qualitative test (since kit cannot detect low values) within the non-detectable range, but he may or may not be negative due to low initial values (whether this possibility exists after six months of exposure or not).

Now to resolve this confusion, whether the HIV duo test which includes p24 antigen, HIV-1, or HIV-2 antibody test at a standard laboratory with more than six months period should be done or you suggest some other test to resolve this problem.

Should he go for HIV rapid test along with this test to double-check it? Please also tell whether the window period of one year may be taken to be more accurate or not. These specific clarifications are required for being a patient of OCD (Obsessive Compulsive Disorder).

Please give a convincing reply, highlighting the use and preference of HIV PCR qualitative test, particularly the HIV-2 graph for viral load vs time period which is not available on websites even.

Thanks and regards.

Hi doctor,

This is regarding the index value of the HIV duo or combo test. Here, the reference value is 1, and values <1 are treated as nonreactive, and values =>1 are treated as reactive. Theory tells that numerical values <1, say, .05, 0.2, 0.5, 0.8, and 0.9, etc., are not linked with HIV status; that is, values in increasing order have no correlation to the probability of becoming HIV positive.

However, some websites say that the value between 0.9 to 0.99 is equivocal and may require a retest so such things create confusion as at which point one should be convinced that he is clearly nonreactive.

Should it be taken as 0.6 or 0.7 or 0.8? What are the reasons for the variation of these values? Some reputed laboratories give index values in the report however, other laboratories give only reactive or non-reactive values.

They both use CMIA architects for this test so they should be equally reliable. You being master of this field, explain in detail what are the facts and if someone has OCD, what steps he should take for this test.

Thank you.

Hi doctor,

This is regarding the seroconversion time in HIV infection. Please refer to a case history in which a person is diabetic taking around 50 units of human mixtard insulin 30/70 along with the tablet Sitagliptin 100 mg and the tablet Reclimat twice a day. He takes around 100 ml of whisky four times a week.

He has been a diabetic for the last 25 years and has been taking insulin for the last ten years. At present, he is in his early sixties, and he goes for yoga and brisk walks regularly. Please explain what his window period shall be for the HIV-1 or HIV-2 antibody test and the accurate result.

Whether diabetes and alcohol intake affect the window period of antibody formation, we often hear news regarding HIV infection being caused by food items.

A case of freshly made salad containing beetroots, tomatoes, red onion, etc., which has fresh HIV infected high viral load blood from the waiter's finger cut and served in an AC restaurant. It is immediately consumed by a person with bleeding gums, cuts, and abrasions in his mouth.

In such a situation, what are the chances of transmission of HIV infection? The HIV virus survives for a long duration in low temperatures, as per the literature, and has a high viral load. Please give a point-wise reply in detail to understand the case.

Thanks and regards.