Human Immunodeficiency Virus Ribonucleic Acid Testing, also known as HIV RNA testing is a type of HIV testing aimed at the early detection of HIV in a person. It is a recent type of testing compared to other existing HIV screening or testing. To know more about the HIV RNA test, check out the information listed below:

What Is HIV RNA test?

HIV RNA test is an early detection testing the presence of the Human Immunodeficiency Virus (HIV) in a person’s body. Unlike other testings that check the presence of antibodies for HIV in the sample, HIV RNA testing checks for the actual presence of HIV by looking for HIV ribonucleic acid (RNA) in the blood sample.

This HIV RNA is present in the bloodstream of a person as soon as they are infected with HIV and it begins to destroy the CD4 cells of the immune system.

The term “early detection” means that the presence of HIV can be accurately detected within 9-11 days after contracting the virus - this is the shortest testing window in comparison to other HIV testings available.

Hiv Rna Test Exposure Window Period

Why wait for 9-11 days?

HIV is a virus that stores its genetic information in an RNA instead of DNA. This genetic information or material does not develop up slowly unlike antigens and antibodies but it is already present in your body as soon as the contraction of HIV and the viral load of the virus is usually high enough in such a way that it is detectable within 9 to 11 days.

How to get HIV RNA test?

Below are the steps on how to get tested:

  1. Select the HIV RNA test package online.
  2. Enter your zip code to find the nearest testing center from you.
  3. Enter the required information in the form. This information will remain private and not publicized.
  4. Pay for the amount of the HIV RNA test package.
  5. You will receive a form for lab request along with a testing code as well as the address of the testing facility.
  6. This form and testing code shall be brought along the testing facility.
  7. Go to the facility. From there you will have a blood sample drawn which will be subjected to testing. This process should take no more than 5 minutes.
  8. Results will be available and viewable online within 1-2 days.
  9. If you have been diagnosed as HIV-positive, a doctor will be available for consultation and counseling via phone.

What is the scientific process of HIV RNA testing?

HIV RNA Testing is conducted via Polymerase Chain Reaction (PCR). PCR is a scientifically accepted method of studying genetic information from the specimen, usually a blood sample. This blood sample contains deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) which are molecules that contain specific genetic information. The DNA and RNA in the sample are amplified by duplicating it billion times until it is large enough to have its genetic information studied in detail. Among the billions of DNA and RNA, it is checked if there is any presence of HIV RNA. HIV RNA only exists in the bloodstream of a person if they have been infected with HIV. If HIV RNA is detected in the sample, it means that the person has HIV.

Do HIV RNA test results contain information about viral load and CD4 cells count?

No. HIV RNA test does not: do the following:

  • Investigate the antibodies for HIV, unlike the standard testing.
  • Provide any information about the count of CD4 Cells.
  • Look for pb24 antigens within the sample.

To put it simply, HIV RNA testing simply checks for the RNA of HIV within the specimen. However, these tests can be conducted as confirmatory tests if the HIV RNA tests yield results that the subject is HIV-positive.

How does HIV RNA Test compare with other testing?

Below is a comparison of all the current HIV testings.

Testing

Testing Process

Testing Window Period

Accuracy

Pricing

Standard HIV-1/HIV2 Test

Checks antibodies for HIV

3 months after contraction of HIV

Up to 99.9%

$79

P24 Antigen Test (4th Generation Test)

Checks for P24 antigens and

3-12 weeks after the contraction of HIV

99.9%

$70

HIV RNA Test

Checks HIV RNA

9-11 days after the contraction of HIV

95 to 99%

$169

Is there a separate confirmation test conducted after HIV RNA test?

Although there is no standard confirmatory test for each testing, most HIV testings that yield a positive result are followed through with a confirmatory test. The results of HIV RNA testing are thoroughly reviewed by:

  • Making a comparison of the viral load count in the sample versus the minimum count required to diagnose an HIV-positive result.
  • Physicians will check all results prior to release.

The most accurate confirmatory test is the Western Blot Test, which is commonly used after the standard HIV screening test. During the Western Blot Test, the blood proteins and HIV antibodies which are protein too are separated and look for specific antibodies for HIV. Having this type of confirmatory test makes the accuracy of the diagnosis up to 99.99%.

How accurate is HIV RNA testing?

HIV RNA test uses the polymerase chain reaction (PCR), a widely accepted scientific method of testing. If done in the proper testing window period, its accuracy is up to 99.89%. The longer you wait from the date of contraction of HIV, the more accurate the testings would be but earlier treatment should also be prioritized.

When should I seek for HIV RNA testing?

As with other testings, you should check for HIV screening as soon as you suspect yourself from being infected with HIV. There are three factors you should consider:

  1. You’ve engaged in sexual activities (oral, anal and vaginal sex) with an HIV-positive person.
  2. You’ve shared medical equipment that led to an exchange of bodily fluids) with an HIV positive person.
  3. You’ve committed such activities 9-11 days ago.

What are the advantages of detecting HIV at an early stage?

The detection of HIV from a person within two weeks after being infected is a significant milestone in the scientific community as well as the HIV-positive population. There are many advantages to early detection of HIV such as:

  1. Early administration of antiretroviral therapy. Early administration of HIV drugs means that the virus is suppressed at an early stage and there are fewer CD4 cells killed - thereby less damage is done to your immune system. Once ART is administered and the patient responds well to treatment, they have better chances of having fewer complications and suppressing the progression of the virus consequently having a better quality of life.
  2. Early assessment of other tests. People who have contracted HIV are also at risk of other sexually transmitted diseases which can have no symptoms at all. If they have been diagnosed with HIV, patients are also tested for other STDs such as chlamydia, syphilis, hepatitis, herpes, and gonorrhea. If diagnosed at an early stage, treatment for this along with HIV can be done more effectively.
  3. Prevents the spread of HIV. A person diagnosed with HIV at an early stage has a higher chance of preventing the spread since he is already informed of his condition. Here are some ways as to how he can prevent the spread:
    1. If a person has been diagnosed with HIV and he has multiple partners, it is wise to inform his partners as well so they can be tested too.
    2. If a person diagnosed with HIV at an early stage continues to engage in sexual activities they can practice safe sex by using condoms or taking PrEP can be done by their partners too.
    3. Stop or disengaging from risky activities. Disengaging from any sexual acts or activities that risk other people from exposure to the virus through you (e.g. sharing of medical equipment) also decreases the chances of spreading the virus to other people.
  4. Decrease the risk of transmission to an unborn child. If a pregnant woman is diagnosed with HIV at an early stage, her doctor can provide a better treatment plan on how to decrease the possibility of transmitting the virus to her child. By having an early treatment for HIV, the virus’s activity is suppressed and its viral load is pushed to a very low level to the point wherein it is undetectable and has less risk of transmission to a child.
  5. Disclosure to family and employer. While there can be some prejudice about people having HIV, those who have it detected at an early stage can disclose this condition to their families and employer. This information is considered private and sensitive but disclosing it is ethical and is important in case there are any emergencies or lifestyle changes that need to be implemented as part of treatment. If you are employed in a public facility, this gives your employer a chance to assess options on how to assist you to improve your quality of life.

Why is it important to have early detection of HIV?

HIV does not present symptoms in all cases. For some people who have been infected with it, symptoms are asymptomatic and usually appear as flu-like symptoms. This causes people to disregard such symptoms as anything serious and so the virus continuously damages the immune system by killing CD4 cells and leads to the progression of HIV to AIDS. Below are some important factors why early detection is important:

  1. Avoid progression into AIDS. If HIV has progressed to AIDS, only then severe symptoms will appear and greatly affect the health and daily life of the person affected. At this point life expectancy drops to 3 months - 6 years.
  2. Improve the quality of life. Early treatment means less risk of getting complications and suppressing the progressing of the virus, with these an HIV-positive person can continue living life like a normal person.
  3. Avoid the spread of the virus to other people. With early detection, people who are diagnosed with HIV can be informed and engage in methods to prevent infecting others. Such methods include avoidance of sharing needles and syringes when using drugs or practicing abstinence or safe sex.

FAQs about HIV RNA testing

Can HIV RNA be done under confidentiality?

Testing and its results are considered private and sensitive information so all of it is done under confidentiality. Only the patient or an authorized person will be able to see what tests were taken and its results.

Is a doctor’s referral needed?

No. HIV tests do not require a doctor’s referral as it can be voluntary and can be done in many healthcare facilities - this also saves paying for the doctor’s consultation fee.

Can I view my HIV RNA testing result online?

Yes. Results can be viewed online by logging into a secure platform and viewing the details of your test results.

What is indicated in the results of HIV RNA Testing?

  • In the “Value” column there are three possible indications, they are listed below with their respective meaning:
  • In the “Result” column, they will either indicate the following:
  • Not-Detected.This means that no presence of HIV was detected in the blood sample.
  • Non-Reactive.This means that no presence of HIV was detected in the blood sample.
  • Reactive. This means that HIV was detected in the blood sample.
  • Positive. It means you have HIV.
  • Negative. It means you are HIV-positive.

The price of HIV RNA testing is quite expensive compared to other HIV testings, is it worth it?

The significant difference for HIV RNA testing with other tests is that it is aimed at the early detection of HIV in a person. With HIV RNA test, HIV can be diagnosed 2 weeks to 2.5 months earlier compared to other tests and this time can make a significant difference in terms of the effectivity of treatment and prevention of the spread of the virus to other people. The advantages and importance of early detection definitely outweigh the price of HIV RNA test.

Additionally, note that the process of HIV RNA testing is intense and time-laboring compared to other tests.

Mark Riegel, MD
Mark Riegel, MD
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