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USA/Australia testing
Hello Dr.’s,
While doing some research on this site and others I have come across some conflicting information from the CDC vs. the SHC. I was curious to know why Australia publicly says that antibody testing at 6 weeks is conclusive, while here in the US they say the 3 month mark is conclusive (sometimes even 6 months or longer at certain offices/clinics). I know you have said several times on this site, that the CDC just simply cannot afford to take a hit of being wrong/sued, but does it have ANYTHING else to do with the tests being used, and wouldn’t Australia be worried about the same “hit of a lawsuit”? For example, are they more advance with tests, education, funding etc? If everyone in Australia could live peacefully off of a 6 week tests, then why can’t the people here in the states do so too? Obviously we are more advanced than what the CDC recommends or else both of you would not be so confident saying that the 8 week tests are conclusive.
Also, I have seen if one has a high risk situation one suggests that they get tested past the 3 month mark, and if one has a low risk situation the 3 month mark would be conclusive. This is also confusing because even if it was high risk or low risk wouldn’t it show up by the 3 months (considering this person is an average Joe not on Chemo or any Anti-HIV meds). Your professional and personal opinion would be interesting to hear. Thanks!
While doing some research on this site and others I have come across some conflicting information from the CDC vs. the SHC. I was curious to know why Australia publicly says that antibody testing at 6 weeks is conclusive, while here in the US they say the 3 month mark is conclusive (sometimes even 6 months or longer at certain offices/clinics). I know you have said several times on this site, that the CDC just simply cannot afford to take a hit of being wrong/sued, but does it have ANYTHING else to do with the tests being used, and wouldn’t Australia be worried about the same “hit of a lawsuit”? For example, are they more advance with tests, education, funding etc? If everyone in Australia could live peacefully off of a 6 week tests, then why can’t the people here in the states do so too? Obviously we are more advanced than what the CDC recommends or else both of you would not be so confident saying that the 8 week tests are conclusive.
Also, I have seen if one has a high risk situation one suggests that they get tested past the 3 month mark, and if one has a low risk situation the 3 month mark would be conclusive. This is also confusing because even if it was high risk or low risk wouldn’t it show up by the 3 months (considering this person is an average Joe not on Chemo or any Anti-HIV meds). Your professional and personal opinion would be interesting to hear. Thanks!
on the above thread you said that only one viruse starts the infection. Does it mean that even only one viruse is enough for transmission of viruse also....
Yes, very very confusing...but i do thank you for trying to put this crazyness into words. It really is terrible that there is so many conflicting resources (some accurate and some not) on the web, and even with our very own Dr.'s that makes us worry so badly and lead us doubting the truth. I guess it all falls back to the 3 month mark if you really need the reassurance- regardless of our risk, however if we have had a test at 6-8 weeks it is a pretty good indicator that they are conclusive right? When you say "virtually everyone" i am assuming you do mean pretty much everyone except those who are very sickly or on chemo. I have also seen on this blog that alot of peoples PCP who seem to be pretty knowledgeable about HIV, say that those who have been diagnosed with HIV are those with the "flashing red lights" such as those who have had hundreds of sexual partners, had a long relationship with an HIV+ person, or who someone who was living a secret life. Is this still correct in 2010?
Dear Dr.Hook you are great man and keep me alive in last 3 months but I have to give some informationton to LBSB.In Australia window period is 12 weks no 6.I have had 6 test on weks 2-6-8 10-11-12.5.My Dr told me i am ok but microbiolog who performed test in labs write that recomended test on 6 and 12 months(he performed 4 gen test ag/ab ECLIA metod)Sorry for this thread but i just want give poster corect info.Once again DR.Hook all the best to you and Dr.H.H.H.
Am i able to make a comment on this thread, general in nature?
MEDICAL PROFESSIONAL
Welcome to the Forum. Unfortunately, here in the U.S. our conservative approach to testing puts us at a disadvantage. In Australia and Western Europe, you actually do have access to better tests as you can be tested for HIV with the DUO tests which detect both HIV antigen and HIV antibody, thereby providing positive results even sooner following infection than antibody tests alone (HIV antigen may be detectable before HIV antibody tests are). The U.S. FDA which must approve tests for HIV testing is in the process of evaluating the DUO tests for U.S. use but has not yet approved them. Typically both new drugs and new tests are available in the countries of Western Europe and Australia because of the conservatism of the U.S. approach.
In addition, as I have said before "The recommendations for testing at 3 and even 6 months are the result of two factors- data from older tests no longer used (you really do not need to worry about which generation of tests you were tested with, at this time virtually all tests are far more sensitive that they were even 2-3 years ago when the 3 month recommendation was made) and secondly, the fact that some mostly governmental agencies which have to provide recommendations for virtually everyone without the sort of interactions such as those you get with your doctor or n-on personalized sites such as this, feel the cannot "afford" to be wrong and therefore make recommendations and guidelines which leave most people unnecessarily nervous for 4-6 weeks longer than the 6-8 weeks it takes virtually everyone to develop HIV antibodies."
Following from this statement, there is no biological reason that a person should test for a longer period than someone following a low risk exposure. It turns out that HIV infection is typically due to a single virus starting the infection. However, there is a statistical reason for sometimes suggesting testing for a longer period following high risk exposures. If something happens only a fraction of 1% of the time, persons who have had higher risk exposures are more likely to be in that fraction of 1%. Thus if 1 in 10,00o people who have acquired HIV will take longer than 6-8 weeks to have a positive tests, persons with high risk exposures are more likely to be that person than persons with low risk exposures because the are more likely to be infected in general.
Hope this makes sense, it's complicated. EWH.
In addition, as I have said before "The recommendations for testing at 3 and even 6 months are the result of two factors- data from older tests no longer used (you really do not need to worry about which generation of tests you were tested with, at this time virtually all tests are far more sensitive that they were even 2-3 years ago when the 3 month recommendation was made) and secondly, the fact that some mostly governmental agencies which have to provide recommendations for virtually everyone without the sort of interactions such as those you get with your doctor or n-on personalized sites such as this, feel the cannot "afford" to be wrong and therefore make recommendations and guidelines which leave most people unnecessarily nervous for 4-6 weeks longer than the 6-8 weeks it takes virtually everyone to develop HIV antibodies."
Following from this statement, there is no biological reason that a person should test for a longer period than someone following a low risk exposure. It turns out that HIV infection is typically due to a single virus starting the infection. However, there is a statistical reason for sometimes suggesting testing for a longer period following high risk exposures. If something happens only a fraction of 1% of the time, persons who have had higher risk exposures are more likely to be in that fraction of 1%. Thus if 1 in 10,00o people who have acquired HIV will take longer than 6-8 weeks to have a positive tests, persons with high risk exposures are more likely to be that person than persons with low risk exposures because the are more likely to be infected in general.
Hope this makes sense, it's complicated. EWH.
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