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New Test Finds HIV in Earlier Stages
  Atlanta Journal-Constitution
Feb 11, 2004
David Wahlberg
North Carolina officials discovered an HIV outbreak among black male college students using an RNA test for HIV, which can detect fragments of the virus two weeks after infection, compared to a routine test that finds antibodies to the virus a month or more after infection. The new test could allow doctors to identify patients days after infection, when they are biologically most able to spread the virus and often continuing to take risks.
"It could be an extremely effective method of finding people very close to the time they are infected and allow us to notify their partners very quickly," said Ida Onorato, deputy director of science for CDC's division of HIV/AIDS prevention. "But it's not so straightforward that this is something that we should be doing."
The RNA method adds $2 to HIV tests - which now run about $4 per kit - not including lab and staff time or tracking down newly infected people. If used on a mass scale, officials worry that a potentially substantial number of false positives could create undue fear.
The San Francisco Department of Public Health is conducting an RNA testing pilot study, Onorato said, and CDC plans to offer grants this spring for other areas to consider RNA testing. Georgia health officials said they might apply for some of the funds.
For years, blood banks have been using versions of the RNA test to screen blood for HIV. North Carolina began to use the RNA test for diagnosis and surveillance in November 2002, and has since used it on all the roughly 125,000 specimens collected each year at 110 public clinics.
Dr. Peter Leone of the North Carolina Department of Health and Human Services said the testing program costs about $250,000 a year, roughly the cost of treating one HIV patient over a lifetime. The state, he said, has discovered 28 newly infected people through the test, whose cases might otherwise not have been reported for week, months or years. The first 22,000 tests led to two false positives.
CDC's Onorato said the test might be most appropriate in places with a significant amount of HIV transmission.
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