Diagnosing acute HIV infection: The performance of quantitative HIV-1 RNA testing (viral load) in the 2014 laboratory testing algorithm

J Clin Virol. 2017 Aug:93:85-86. doi: 10.1016/j.jcv.2017.02.005. Epub 2017 Feb 15.


New recommendations for laboratory diagnosis of HIV infection in the United States were published in 2014. The updated testing algorithm includes a qualitative HIV-1 RNA assay to resolve discordant immunoassay results and to identify acute HIV-1 infection (AHI). The qualitative HIV-1 RNA assay is not widely available; therefore, we evaluated the performance of a more widely available quantitative HIV-1 RNA assay, viral load, for diagnosing AHI. We determined that quantitative viral loads consistently distinguished AHI from a false-positive immunoassay result. Among 100 study participants with AHI and a viral load result, the estimated geometric mean viral load was 1,377,793copies/mL.

Keywords: Acute HIV infection; Fourth-generation immunoassay; HIV diagnosis; HIV testing; Quantitative HIV-1 viral load.

Publication types

  • Letter
  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • HIV Infections / blood
  • HIV Infections / diagnosis*
  • HIV-1 / genetics*
  • Humans
  • Molecular Diagnostic Techniques
  • Nucleic Acid Amplification Techniques
  • RNA, Viral / blood*
  • RNA, Viral / genetics
  • United States
  • Viral Load


  • RNA, Viral