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HomeAnswersHIV/AIDS specialisthiv testingHow accurate is HIV-1 RNA, QL TMA?

Will HIV RNA, QL TMA be accurate after 21 days of exposure?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

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Published At March 3, 2018
Reviewed AtJuly 25, 2023

Patient's Query

Hello doctor,

Is HIV(Human Immunodeficiency Virus) RNA (Ribonucleic Acid), QL TMA (Qualitative transcription-mediated amplification) accurate after 20 to 21 days of exposure? And also this came with my results. RNA is not detected. No laboratory evidence of HIV infection. The HIV-1 RNA qualitative TMA assay is recommended for use as part of a multi-test HIV-1/HIV-2 screening and diagnostic algorithm. This assay can also be used to resolve indeterminate HIV-1 antibody assay results, and to test for HIV-1 infection in patients less than 2 years old. When a fourth generation HIV multi-test screening and diagnostic algorithm is used, if the test results include a repeatedly reactive HIV-1/2 antigen/antibody (fourth generation) screen, followed by negative confirmatory tests for HIV-1 and 2 antibodies and HIV-1 RNA by TMA, the most likely interpretation is a non-specific (biological false positive) reaction in the fourth generation screening assay. There is no current laboratory evidence of HIV infection. Repeat testing on a second specimen is not generally indicated but may be appropriate if there are known risk factors for recent HIV exposure. If the recent HIV-2 infection is suspected, additional testing by HIV-2 DNA(deoxyribonucleic acid) or RNA, qualitative, real-time PCR (Polymerase chain reaction) should also be considered. Can someone explain this to me?

Answered by Dr. Sushil Kakkar

Hi, Welcome to icliniq.com.

HIV RNA PCR test is accurate after 9 to 13 days after the risk exposure. It can be used to detect early infection with HIV when most other screening tests are not yet reliable. However, it is not a confirmatory test and an early screening with RNA PCR should be followed by a more sensitive and specific screening test, this is the fourth generation antigen-antibody HIV screening test at four weeks and at 12 weeks. Therefore, RNA PCR is quite useful in the detection of early infection. Other times this test can be useful as a second test after an indeterminate fourth generation HIV screening test or when a positive HIV screening test is followed by a negative confirmatory test (usually a western blot). In the second scenario, if RNA PCR turns up as negative then it suggests that an earlier positive screening test was most likely a false positive.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sushil Kakkar
Dr. Sushil Kakkar

Dermatology

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