HIV viral load

Q: HIV-1 RNA quantitation (Viral load for HIV) can be misleading in which of the following conditions

A) acute illness 
B) outbreak of herpes simplex infection 
C) vaccination against influenza 
D) vaccination against tetanus
E)  all of the above 


Answer:  E

As patients with HIV infection get admitted to ICU with acute illness frequently, it is of importance to know that viral RNA levels can be misleading and dramatically falsely elevated during acute illness, herpes simplex infection outbreak, or vaccination against many pathogens like influenza, pneumococcus, and tetanus. It takes about a month for values to return to baseline.



References:

1. Donovan RM, Bush CE, Markowitz NP, et al. Changes in virus load markers during AIDS-associated opportunistic diseases in human immunodeficiency virus-infected persons. J Infect Dis 1996; 174:401. 

2. Mole L, Ripich S, Margolis D, Holodniy M. The impact of active herpes simplex virus infection on human immunodeficiency virus load. J Infect Dis 1997; 176:766. 

3. O'Brien WA, Grovit-Ferbas K, Namazi A, et al. Human immunodeficiency virus-type 1 replication can be increased in peripheral blood of seropositive patients after influenza vaccination. Blood 1995; 86:1082. 

4. Staprans SI, Hamilton BL, Follansbee SE, et al. Activation of virus replication after vaccination of HIV-1-infected individuals. J Exp Med 1995; 182:1727.