Vojnov L, Penazzato M, Sherman G, Ghadrshenas A, Abrams EJ, Doherty M.
J Acquir Immune Defic Syndr. 2019 May 29. doi: 10.1097/QAI.0000000000002081. [Epub ahead of print] No abstract available.
Currently, most programs and laboratories interpret undetectable test results by the nucleic acid-based technology as negative and detectable test results as positive, relying on thresholds of detection provided by the manufacturers; however, there is increasing concern in how to interpret test results with low levels of viremia, particularly in the context of increasing exposure to antiretroviral treatment and prophylaxis. To date, there has been limited guidance on how to interpret low levels of viremia in test results. However, historically one would hesitate to initiate lifelong treatment based on detection of the equivalent of very few viral copies per milliliter a true positive result. In this context, different approaches have been considered: guidelines in the United States suggest that infants should not be considered HIV-positive unless they have the equivalent of 5,000 viral copies/ml or higher, while South Africa has introduced an indeterminate range that requires further testing before a definitive test result is provided and treatment initiated.