Utility of an HIV-1 RNA assay in the diagnosis of acute retroviral syndrome.
Highly active antiretroviral therapy (HAART) begun during primary infection with human immunodeficiency virus type 1 (HIV-1) can preserve immune function and may alter the long-term clinical course of HIV-1 infection. To diagnose primary HIV-1 infection (PHI) early, when screening serologies may yield negative or indeterminate results, the Department of Health and Human Services recommends the use of an HIV-1 RNA assay for at-risk patients suspected of having acute retroviral syndrome (ARS). Because of the RNA assay's 1.9% to 3.0% false-positive rate, results must be carefully interpreted and compared to HIV-1 viral load levels seen during proven HIV-1 seroconversion. We report the case of a sexually active woman with symptoms suggestive of ARS who had a false-positive HIV-1 RNA assay result. We discuss use and interpretation of the HIV-1 RNA assay in diagnosing PHI.
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Department of Internal Medicine, Wilford Hall Medical Center, Lackland AFB, Tex 78236, USA.
O'Brien
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Walter
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D015492:AIDS Serodiagnosis / Q000379:methods*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005189:False Positive Reactions; D005260:Female; D015497:HIV-1; D006801:Humans; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013997:Time Factors; D014481:United States; D019562:Viral Load