Charmagne Goodman, MD; Wesley Emmons, MD; James Newton, MD
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Goodman C, Emmons W, Newton J. Misdiagnosis of HIV Infection. Ann Intern Med. 1999;131:547. doi: 10.7326/0003-4819-131-7-199910050-00030
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Published: Ann Intern Med. 1999;131(7):547.
TO THE EDITOR:
Rich and colleagues (1) described three patients given a false diagnosis of HIV-1 infection on the basis of falsely positive HIV-1 plasma viral load test results. The authors urged caution in using HIV-1 plasma viral load testing to diagnose HIV infection. We agree, and urge caution for the converse: Viral load testing should not be used to exclude a diagnosis of HIV-1 infection. We reviewed the charts of the 324 seropositive patients enrolled in our HIV clinic and found 13 patients (4%) receiving no antiretroviral therapy who had plasma viral loads less than 400 HIV RNA copies/mL; 6 of these patients had viral loads less than 50 HIV RNA copies/mL according to an ultrasensitive assay (Table). Viral load testing was done with the reverse transcriptase polymerase chain reaction (PCR) assay (Amplicor, Roche, Basel, Switzerland). Of note, each patient also had a relatively preserved immune status on the basis of absolute CD4 counts, percentage of CD4 cells, and ratios of helper to suppressor cells.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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