the exposure was in India so HIV 2 is a concern. DUO test was a negative after 3 months but there are reports online of carriers of the HIV 2 virus in India who somehow did not seroconvert (would really appreciate if someone go through the article). My question is, can PCR RNA detect both HIV 1 and 2 virus and all subtypes if the DUO missed it? Is this the right test for this situation for patients who do not seroconvert? thank you.
Hi there and thanks for reaching out to AIDS Vancouver. My name is Colin and I'm happy to answer your questions today.
I understand you have questions about the effectiveness of the PCR RNA test in detecting HIV 2. I hope the information I have today can help put your mind at ease.
First of all, the DUO Test you took is the most modern commonly-administered HIV test available and already tests for HIV 1 and HIV 2. Though we use a slightly more conservative timeline here at AIDS Vancouver and say that this test would be considered conclusive at 3 months post-exposure, most HIV experts and the WHO consider a DUO Test to be conclusive at 6 weeks. Therefore, as it seems like you took your DUO test after 3 months, its results can be considered conclusive for both HIV 1 and HIV 2 and without a new exposure its results will not change.
Specifically regarding the PCR RNA test, though it shouldn't be necessary given your conclusive DUO Test result, if you decide to get additional testing, the PCR RNA test will also screen for HIV 1 and HIV 2 RNA.
Lastly, when you ask if this is the right test for people who do not seroconvert, the short answer is "maybe." When you say there are carriers of the HIV 2 virus who did not seroconvert, those two things cannot both be true. There are some people called long-term non-progressors or "Elite Controllers" who are people who have acquired HIV but whose immune systems are somehow able to keep the virus at undetectable levels. Even though these people do not present with symptoms and their HIV is not causing noticeable harm to their bodies, they still have seroconverted. And even in these people who have naturally undetectable levels of virus, or in people who's viral loads are undetectable due to effective antiretroviral therapy, a PCR RNA test will still detect the virus.
I hope the information I've been able to provide can give you some peace of mind. Please feel free to post again if you'd like more information or clarification.
All the best,
AIDS Vancouver Helpline