Aa
confused about 4th generation test
Dear all, I have some questions, some of them you will may sound stupid or anxious, but I do welcome your straight answers, not to appease me but to inform me correctly.
1.
I am confused about the validity of the DUO test I took 7 weeks after a high risk exposure (anal receptive with gay male). I read that the DUO test is very accurate at 4 weeks only because after that the P24 antigen becomes undetectable. I fear I have a missed an opportunity not to have taken this test at 4 weeks. But since my test at 7 weeks was negative for antibodies also, would it not make sense to believe that the antigen in my cased would still be detectable at 7 weeks. Otherwise said would the antigen remain detectable as long as antibodies are not formed yet.
2.
I also tested negative with a a DUO at 22 weeks. If I would adher to the conservatice (official CDC) guideline of conclusive testing at 6 months, can this 22 weeks be accepted as 5,5 months (based on one month equals 4 weeks of 7 days) or does it only equal 5 months (based on calendar months of 30-31 days).
3.
What is the likelihood of a 22 weeks negative turning positive at 24 or 25 weeks (to reach the 6 months timeline) providing no other risk exposures have occurred?
4.
If i would be one of those rare delayed seroconvertors, would I then not be more at risk to develop AIDS soon given the lack of my body producing antibodies.
5.
In the expert forum I was told that my risk of still turning positive is virtually zero. Why not saying zero, because this 'virtually' is like saying: you are fine, but it is not impossible that....
I admit I am lost in fear, and I am working on it with my therapist, but here I count on specific - clinical - answers.
Please advice,
1.
I am confused about the validity of the DUO test I took 7 weeks after a high risk exposure (anal receptive with gay male). I read that the DUO test is very accurate at 4 weeks only because after that the P24 antigen becomes undetectable. I fear I have a missed an opportunity not to have taken this test at 4 weeks. But since my test at 7 weeks was negative for antibodies also, would it not make sense to believe that the antigen in my cased would still be detectable at 7 weeks. Otherwise said would the antigen remain detectable as long as antibodies are not formed yet.
2.
I also tested negative with a a DUO at 22 weeks. If I would adher to the conservatice (official CDC) guideline of conclusive testing at 6 months, can this 22 weeks be accepted as 5,5 months (based on one month equals 4 weeks of 7 days) or does it only equal 5 months (based on calendar months of 30-31 days).
3.
What is the likelihood of a 22 weeks negative turning positive at 24 or 25 weeks (to reach the 6 months timeline) providing no other risk exposures have occurred?
4.
If i would be one of those rare delayed seroconvertors, would I then not be more at risk to develop AIDS soon given the lack of my body producing antibodies.
5.
In the expert forum I was told that my risk of still turning positive is virtually zero. Why not saying zero, because this 'virtually' is like saying: you are fine, but it is not impossible that....
I admit I am lost in fear, and I am working on it with my therapist, but here I count on specific - clinical - answers.
Please advice,
You are not making sense at all. The guidelines come from scientific data from the manufacturers of the HIV tests that is submitted to the FDA. The data is from people who seroconvert, not uninfected people. The data shows that 3 months is conclusive- it iis not some made up time period. That is all I have to say. I refuse to continue to entertain your irrational concerns as it will only lead to more questions. I suggest that yoi seek professional mental help if you can't accept your test results. This thread is now CLOSED.
Thank you Joggen.
I seed the document comes from the CDC source.
But why have they not updated the guideline on the main website where the 'old' procedure is still mentioned?
And why at the body.com the experts still push the 6 month window forward?
It might be related to my anxiety, but I find this a little suspicious.
As if 'they' say 3 months is ok for most people with the only reason not to 'fuel the panic' but knowing that some people do seroconvert later.
How do they know that 3 months or 6 months is ok. These periods look like 'random'. On which basis have they come to these conclusions? Sometimes I think it is because most people are indeed not infected and thus do not make antibodies at 3 months (because they were never infected in the first place), and if they include all these people (the vast majority) in the study material, then of course it is 'easy' to say that most people get conclusive results after 6 to 8 weeks (or 3 months). And the exceptions are the few people who actually are infected, and since there are so little people who get HIV, they are nearly all 'rare' cases, but who knows of these real infected people, when was the time they seroconverted. Maybe these are most part of those 'rare' people who take longer than 3 months to convert since 99% of the people included in the study WERE NEVER INFECTED ANYWAY. How reliable would all this be?
Tell me I am seeing this completely wrong (one part of me tells it to myself that I am looking for proof of bias, but another part of me has an anxious feeling that the experts themselves do not really know it very well themselves, and thus they say 3 months and 6 months because these are nice round numbers and reflect generally accepted standards used for all kind of non-HIV related infections.
Imagine that the fully conclusive HIV test would take as long as 1 year, this would be unbearable for most people to deal with...
Is this my paranoia or could this made sense?
I seed the document comes from the CDC source.
But why have they not updated the guideline on the main website where the 'old' procedure is still mentioned?
And why at the body.com the experts still push the 6 month window forward?
It might be related to my anxiety, but I find this a little suspicious.
As if 'they' say 3 months is ok for most people with the only reason not to 'fuel the panic' but knowing that some people do seroconvert later.
How do they know that 3 months or 6 months is ok. These periods look like 'random'. On which basis have they come to these conclusions? Sometimes I think it is because most people are indeed not infected and thus do not make antibodies at 3 months (because they were never infected in the first place), and if they include all these people (the vast majority) in the study material, then of course it is 'easy' to say that most people get conclusive results after 6 to 8 weeks (or 3 months). And the exceptions are the few people who actually are infected, and since there are so little people who get HIV, they are nearly all 'rare' cases, but who knows of these real infected people, when was the time they seroconverted. Maybe these are most part of those 'rare' people who take longer than 3 months to convert since 99% of the people included in the study WERE NEVER INFECTED ANYWAY. How reliable would all this be?
Tell me I am seeing this completely wrong (one part of me tells it to myself that I am looking for proof of bias, but another part of me has an anxious feeling that the experts themselves do not really know it very well themselves, and thus they say 3 months and 6 months because these are nice round numbers and reflect generally accepted standards used for all kind of non-HIV related infections.
Imagine that the fully conclusive HIV test would take as long as 1 year, this would be unbearable for most people to deal with...
Is this my paranoia or could this made sense?
http://www.cdc.gov/nchstp/od/gap/pmtct/Trainer%20Manual/Adobe/Module_6TM.pdf
Page 11, number 4
Page 11, number 4
Dear Joggen,
Despite my sometimes irrational fears, reading clear cut replies from people like you do have a reassuring effect on me. So thank you for providing that.
You say that CDC uses 3 months as conclusive since 2004. I have read this also in posts from Teak and Lizzy on the prevention forum. However, I have never found on the website of CDC any document stating that 3 months is conclusive. In the official guidelines on the website the 6 months guideline is still referred to.
Can you please show me where I can find the CDC's recommendations on 3 months.
I am sure it will help many people here too as a lot of doubt comes especially from CDC using different approaches than in the rest of the world.
Happy new year
Despite my sometimes irrational fears, reading clear cut replies from people like you do have a reassuring effect on me. So thank you for providing that.
You say that CDC uses 3 months as conclusive since 2004. I have read this also in posts from Teak and Lizzy on the prevention forum. However, I have never found on the website of CDC any document stating that 3 months is conclusive. In the official guidelines on the website the 6 months guideline is still referred to.
Can you please show me where I can find the CDC's recommendations on 3 months.
I am sure it will help many people here too as a lot of doubt comes especially from CDC using different approaches than in the rest of the world.
Happy new year
"thank you for answering. However, I still am a bit confused. You say that antigen component is no longer detectable after 4 weeks because of the presence of antibody. So, in case of late antibody production would the antigen then remain detectable for longer time (until antibodies are produced)?"
Yes, after 4 weeks either antibody or antigen is going to be present. Reread Dr. Hook's reply to you.
"I just want to know if my DUO test at 7 weeks was valuable for antigen detection given the fact that I have not produced antibodies yet at that time."
You seemed to have missed my point- at 7 weeks almost everybody who is infected with HIV produced antibodies. But rest assured if you didn't, the antigen component would be positive.
"Why is the official testing guideline in France (using combitests at 6 weeks) so different from the CDC guidelines in US (still using 6 months as conclusive). France has always been a pioneer in the whole HIV research, so I assume they know what they are talking about."
The CDC uses 3 months as conclusive for antibody testing as does the rest of the world. It's been that way for the CDC since 2004. The DUO tests have an earlier window period because they were designed for early detection. The point you need to understand is that you are conclusively HIV NEGATIVE by every standard in the world.
You need to stop overanalyzing this and accept that you don't have HIV. Believe what Dr. Hook told you- you spent $20 for his expert advice.
Yes, after 4 weeks either antibody or antigen is going to be present. Reread Dr. Hook's reply to you.
"I just want to know if my DUO test at 7 weeks was valuable for antigen detection given the fact that I have not produced antibodies yet at that time."
You seemed to have missed my point- at 7 weeks almost everybody who is infected with HIV produced antibodies. But rest assured if you didn't, the antigen component would be positive.
"Why is the official testing guideline in France (using combitests at 6 weeks) so different from the CDC guidelines in US (still using 6 months as conclusive). France has always been a pioneer in the whole HIV research, so I assume they know what they are talking about."
The CDC uses 3 months as conclusive for antibody testing as does the rest of the world. It's been that way for the CDC since 2004. The DUO tests have an earlier window period because they were designed for early detection. The point you need to understand is that you are conclusively HIV NEGATIVE by every standard in the world.
You need to stop overanalyzing this and accept that you don't have HIV. Believe what Dr. Hook told you- you spent $20 for his expert advice.
Dear Joggen,
I was incorrect. The HAS (Haute Autorité de santé), the CDC equivalent in France uses 6 weeks (not 7 weeks) in their testing algorithm using combination tests to determine if one had HIV or not.
There is also an English guide on their website:
http://www.has-sante.fr/portail/upload/docs/application/pdf/2010-02/hiv_infection_screening_in_france_-_screening_strategies_-_executive_summary_2010-02-26_10-28-32_643.pdf
Very interesting and clear information.
Why is the official testing guideline in France (using combitests at 6 weeks) so different from the CDC guidelines in US (still using 6 months as conclusive). France has always been a pioneer in the whole HIV research, so I assume they know what they are talking about.
I was incorrect. The HAS (Haute Autorité de santé), the CDC equivalent in France uses 6 weeks (not 7 weeks) in their testing algorithm using combination tests to determine if one had HIV or not.
There is also an English guide on their website:
http://www.has-sante.fr/portail/upload/docs/application/pdf/2010-02/hiv_infection_screening_in_france_-_screening_strategies_-_executive_summary_2010-02-26_10-28-32_643.pdf
Very interesting and clear information.
Why is the official testing guideline in France (using combitests at 6 weeks) so different from the CDC guidelines in US (still using 6 months as conclusive). France has always been a pioneer in the whole HIV research, so I assume they know what they are talking about.
Dear Joggen,
thank you for answering. However, I still am a bit confused. You say that antigen component is no longer detectable after 4 weeks because of the presence of antibody. So, in case of late antibody production would the antigen then remain detectable for longer time (until antibodies are produced)?
I just want to know if my DUO test at 7 weeks was valuable for antigen detection given the fact that I have not produced antibodies yet at that time.
I also read that in France the CDC equivalent institute has the guideline to test with a DUO at 7 weeks to determine if one has HIV or not. They don't talk about 4 weeks. Is that because of the same reason, that by 7 weeks either the antibody or the antigen would be detectable?
Please comment
thank you for answering. However, I still am a bit confused. You say that antigen component is no longer detectable after 4 weeks because of the presence of antibody. So, in case of late antibody production would the antigen then remain detectable for longer time (until antibodies are produced)?
I just want to know if my DUO test at 7 weeks was valuable for antigen detection given the fact that I have not produced antibodies yet at that time.
I also read that in France the CDC equivalent institute has the guideline to test with a DUO at 7 weeks to determine if one has HIV or not. They don't talk about 4 weeks. Is that because of the same reason, that by 7 weeks either the antibody or the antigen would be detectable?
Please comment
It is impossible that you have HIV. You did not need a DUO test because after 6 weeks detectable antibody is present in almost everybody,.and after 3 months 100% have detectable antibodies. The p24 antigen component is only present 2-4 weeks after exposure, and the reason it disappears is the presence of antibody. But since the DUO also detects antibody, your tests still would have been positive if you were infected.
You must join this user group in order to participate in this discussion.
You are reading content posted in the HIV Anxiety Support Group
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
