What is the HIV RNA Test?

The HIV RNA test is the best option available for early detection. Tests can either measure antigens, antibodies or genetic material of the virus (RNA). Researchers claim that RNA tests are 99% effective, so there is no need to worry about the validity of the findings! Older commonly used HIV tests usually measured the levels of the antibodies that fight HIV, compared to newer RNA-based tests, which detect the presence of the virus itself in the bloodstream.

It actually takes your body up to 3 months to produce a detectable level of antibodies in reaction to the virus. On the other hand, the HIV RNA test detects the virus as soon as it is measurable in the bloodstream, long before antibodies begin to develop.

Having the ability to detect a new HIV infection without the presence of antibodies (the body's proteins that are produced in order to combat infections) in the body’s blood, makes the new HIV RNA test the best and most accurate early HIV detection test available on the market today.

  • RNA Tests have been routinely used to monitor the progression of disease in an HIV-infected person.
  • HIV RNA Tests are used to screen blood donations commonly.
  • The tests have been improved and are now used to diagnose primary (recent) infection.
  • False positives are easily recognized by the testing facility and are automatically retested and compared with the presence or absence of a recognizable viral load.

What does RNA stand for?

RNA stands for ‘ribonucleic acid’, a genetic messenger present in all the body's cells that carries instructions. RNA is the viral equivalent to human DNA. The RNA molecule is essential for various biological coding, decoding, regulating and the expression of certain genes.

How accurate is the HIV RNA Test?

When a person becomes initially infected with HIV, the body begins to replicate the HIV (up into the 100’s of thousands) very fast as the immune system has yet to be compromised. If a RNA test appears to be inconclusive, a viral load test will determine whether a recent exposure actually exists. Since it is the RNA itself that contains certain codes which allows the virus to replicate itself, viral load tests are very accurate down to as low as 20 copies/milliliter.

Viral load is usually high enough 9-11 days after exposure for a positive result.

So what does this mean for you and your results? If you take your test within 9-11 days after a possible exposure, you decrease your chances of having a false positive as the HIV RNA test is not reliable before this time, 90% accurate during this window and 99% accurate around 28 days after exposure.

Hiv Rna Test Exposure Window Period

How HIV RNA Early Detection Test work?

HIV RNA test is one of the HIV tests which is used to detect the presence of the HIV RNA in your body cells if you are infected. The HIV virus is a kind of virus which stores its genetic information in RNA rather than DNA like most other viruses. It infects the body cells after exposure and begins to replicate within them. In the acute stage of the infection, the viral load can get as high as 100,000 or more copies per ml of a sample.

There is no need to overly worry about False Positives or False Negatives, because the actual viral load count will be compared to the minimum count required to have a positive result. Like with any clinical test we provide, your results will be reviewed by an actual Physician, and the best recommendations will be given to you.

The RNA testing is carried out using the PCR (polymerase chain reaction) technique whereby any DNA or RNA in the sample collected is copied and read, making it a quite highly accurate testing method with an accuracy of 99.89% for both HIV types 1 & 2. The longer you wait, the higher the accuracy of the test.

Who can be tested with the HIV RNA Test?

  • Anyone who is known to have potential Exposure to HIV-1 in the past 12 weeks thru
    • Unprotected sex
    • High risk behavior by sharing non-sterile (dirty) needles
    • Exposure to HIV infected blood
  • Infants born to infected mothers
  • Individuals who have received reactive (positive) results on an HIV antibody test
  • Negative or indeterminate results received from supplemental testing

Cost of HIV RNA Testing

When it comes to medical care, most people are concerned with the financial burden and whether or not their insurance can help make that cost easier on them. Before anything else, understand that no matter how much you might think HIV testing like the HIV RNA test costs, the price of good long term medical treatment is vastly cheaper the earlier a person realizes he or she is infected. In other words, definitive treatment is both more cost-effective and generally more effective the earlier a person can get access to it.

Costs will differ depending on the region where you live, the medical facility used and the type of insurance policy a person has. However, if you choose to pay out-of-pocket, the flat pricing averages around $150- $175. Though this form of testing is slightly more expensive than many others, the increase in cost is easily outweighed by the treatment benefits early detection offers.

Testing Process for HIV RNA

The testing process for HIV RNA (Ribonucleic Acid) is convenient and simple. If you are looking to be tested, then follow the steps below.

  • Select your test package.
  • Locate your testing center close to you by entering in your zip code.
  • Fill out the form with your information and make your payment.
  • You will get an email that has a Lab Requisition Form that has a testing code. The address of your testing center will also be included.
  • Print out the form and testing code and take it to the testing center.
  • Get tested in just 5 minutes using a small blood sample.
  • You will receive your results in 1-2 days.
  • If your test is positive, you will have a consultation with a doctor over the phone.

Why Should You Choose the HIV RNA Test ASAP?

Because both HIV and more importantly AIDS can bear such a devastating impact on many human lives. It’s extremely important for persons who are HIV positive realize they are carriers as soon as possible! Not only can this knowledge prevent knowingly transmitting the disease to others, it can also help slow the spread of the long term and devastating condition of AIDS and vastly improve treatment options.

  • About 37 million people are living with HIV/AIDS across the globe.
  • In 2016, about 38,700 people were diagnosed with HIV in the US.
  • According to scientists at the Centers for Disease Control (CDC) one out of every seven people infected with HIV or AIDS aren’t aware of their status.
  • Getting tested is the only way to be sure, and the HIV RNA test is your fastest option!
  • Discovering infection quickly means early access to treatment, and better health chances.

How does HIV RNA Test compare with other testing?

Below is a comparison of all the current HIV tests.

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

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.

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

Although there is no standard confirmatory test for each testing, most HIV tests 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%.

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.

Important, Common Questions

Is Urine or Blood used for the HIV RNA test?

This is a blood test. When you visit the testing center, one of our certified lab techs will take a small sample of blood. You will not need any urine to take this test.

What is the soonest that I can have a HIV early detection test after unprotected sex?

You can have this test between 9 to 11 days after having sex. The window period for HIV RNA testing is the shortest time among all the other tests on the market.

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 often should I be tested?

If you are sexually active, then it should be at least once each year. Yet, if you have had unprotected sex with someone whose status isn’t known, then get tested again.

Do I need to fast before this test?

No. You do not have to fast for this HIV RNA test.

When will the HIV RNA test be considered to be conclusive?

A conclusive HIV test is only considered conclusive after 12 weeks or a retest, however RNA tests can provide accurate results earlier than others.

How long will it take to get results?

It can take between 1 to 2 business days to get your results, but that is only after taking the 5 minutes to be tested. The results are emailed to you.

Is there a possibility of getting a false negative HIV RNA test result?

Even though the RNA test can provide 99% accurate results, there are times when a false positive may happen. This may happen if you have had a test that was done using Pooled RNA NAAT.

What is the range of a normal viral load?

If you are on an HIV treatment or do not have a HIV infection, your viral load should not be detectable. If you have HIV but are not on an HIV treatment, then your viral load could be up to several million.

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.

What is the next step after the HIV test?

It all depends on your result. If it is negative, you do not have to do any other thing. If it is positive however, you would have to take some steps that would confirm your diagnosis so that treatment can be started as quickly as possible. You will be guided and supported every step of the way.

References

Mark Riegel, MD

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