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HIV infection: detection of human immunodeficiency virus (hiv PCR)
Last reviewed: 04.07.2025
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HIV is normally absent from the material.
The PCR method for detecting HIV RNA can be qualitative and quantitative. Qualitative detection of human immunodeficiency virus RNA using PCR is used in the following cases:
- neonatal screening;
- confirmation of the results of screening serological testing;
- screening patients at high risk of infection;
- resolution of equivocal results in immunoblot testing;
- monitoring the effectiveness of antiviral treatment;
- determination of the stage of the disease (transition of infection to disease).
Direct quantitative determination of HIV RNA by PCR allows more accurate prediction of the rate of disease progression in HIV-infected individuals than determination of CD4 + cell count, and therefore more accurate assessment of their survival. High viral particle counts usually correlate with severe immune impairment and low CD4+ cell counts. Low viral particle counts usually correlate with better immune status and higher CD4 + cell counts. Viral RNA counts in the blood help predict progression of the disease to the clinical stage. Individuals with HIV-1 counts in the blood over 10,000 copies/ml are 10.8 times more likely to develop AIDS than individuals with HIV-1 counts in the blood below 10,000 copies/ml. In HIV infection, the prognosis directly depends on the level of viremia. Reducing viremia during treatment improves the prognosis.
A group of US experts has developed indications for therapy of patients with HIV. Treatment is indicated for patients with a CD4 + blood cell count of less than 300 in 1 μl or an HIV RNA level in the serum above 20,000 copies/ml (PCR). The results of antiretroviral therapy of HIV-infected individuals are assessed by a decrease in the serum HIV RNA content. With effective treatment, the viremia level should decrease 10-fold during the first 8 weeks and be below the PCR sensitivity limit (less than 500 copies/ml) 4-6 months after the start of therapy.
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