Accuracy of antibody testing these days?

What's the accuracy at 25 days, 3 months, six months, and beyond six months? I've been hearing mixed things from people who ahouls know.

[Teak]

There are no antibody tests approved for a conclusive result at 25 days. 3 month and longer is 100% as long as you don't fall in the rare catagory which you would know before you even take a test and that you have not had any unprotected exposure prior to the three months before testing.

[Jaguar83]

I'm not sure the question was really answered. I have seen repeatedly that a test at 28 days is 90% accurate (I think HHH). I'm still waiting on my 3 month (got a 54 day neg, couldn't wait). I think it's something like 99.6% (seen that number several places, including HHH).

[Jaguar83]

Hah, although I really don't know much compared to the gentleman above (do not mean to undermine you, sir Teak); point is tests before 3 months ARE NOT conclusive.

[xworriedx]

Call MASS or ask Dr H yourself about 6 weeks testing being conclusive for 99& of people.

[Cjplus]

I'm going to through a wrench in here because this same conversation continues to come up and I just don't understand it. Are we talking about the sensitivity of the tests or the amount of time it takes for someone to seroconvert? Is it an accurate statement that most people (99%) seroconvert within 6 weeks?(I've actually heard 4 weeks) And that when people seroconvert they always produce antibodies? Are there instances when antibodies are present in someone that one of the new ELISA's won't detect the antibodies?

It just seems to me that this debate is really more about when people seroconvert as opposed to the effectiveness of the tests. Maybe I'm not understanding.

[Teak]

We are talking about a conclusive result for a negative test.

[Cjplus]

Yes yes - I gotcha but the accuracy of the test isn't really in question it's whether or not the person has seroconverted or not yet. Right? So that IF someone has seroconverted prior to taking the test the test should be able to give them an accurate result whether it's at 4 weeks, 6 weeks or 3 months. Just want to make sure I have that part of it correct. Thanks

[Cjplus]

I think you're a little out of line. Teak does nothing but help people on this forum and there certainly is no room or reason for name calling and discrediting. People here like to feel like they count on opnions. The bottom line is that Teak's advice is the responsible approach no matter what facts or stats are being verbalized.

I know where you're coming from and and I've heard similar comments about a 6 week negative result indicating that their is a very strong possibility that you are in fact negative. The folks that make the tests stand behind the 3 months and so do most publications. The ones that don't go on to reccomend 6 months. Most GPs still don't know that 6 months is overboard now-a-days unless you fall into that minute 0.005%(not a real stat) of folks who are severely immuno supressed.The medical, research and science professionals working in this field are starting to say that the modern ELISAS or fairly accurate at 6 weeks past exposure but again this is not published information.

[nerviouskid]

it's okay to disagree, but name-calling is not appreciated. Teak does try to help people and answer people's questions to his best knowledge.  He also does seem to know more about this than others...there is a lot of conflicting thoughts and views as far as HIV transmission and testing is concerned, but this forum should be used as a discussion and coming to a logical approach on various views than to vent out fraustrations out of disagreements with fellow members here.

[peekawho]

I respect Teak, but while he is technically correct about the 3 month testing, for most people who had a low risk exposure (which is virtually everyone who posts here), they can and should put HIV out of their minds with a 6-8 week negative result.  All sexually active, non-monogamous people should test once a year, NOT after any specific incident unless it was undoubtably very high risk (unproteced anal/vaginal with a definate HIV pos person, or needle-sharers).  

If someone just has to have that "conclusive" stamp of approval, they will indeed have to wait 3 full months.  But for most, they can relax after 6-8 weeks.  As tests improve, data is accumulated, and people grow balls, the 6-8 week time frame will become the standard eventually.  

For now, he's technically right.  But again, for most testers, 6-8 weeks is very accurate.  

Please, don't call each other names.  It isn't necessary.  

[worrywart97]

Wow, I never knew the forum would turn into a soap opera.   Let's not forget the disclaimer for this forum...All  Questions and Comments posted in the patient to patient forums are provided by individual visitors who are  NOT MEDICAL PROFESSIONALS.  Their questions and comments reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in any of MedHelp's Forums.

I like visiting this website because I have my own anxieties, like everyone else who are in this forum and it's nice to know that I'm not alone.  It doesn't help us if you're belittling someone; however, I do find this thread quite entertaining and actually a distraction for my anxieties.

Besides, if you don't like what is written on this forum, then leave and find another website to express your opinions.

[regularjoey]

OK, People, here is the deal.
I'll just outline what happens early in HIV infection, for those who are confused

Week 1-2  HIV is establishing a systemic infection.  This period is called "eclipse period' sometimes.  No virus can be detected in the blood at this point.
Week 2-3.  The infection is systemic.  Viral RNA and p24 become detectable.  People often experience ARS symtoms (symptoms).  The antibody is usually not detected at this point.
Week 4-6.  Immune response kicks in and the symptoms subside.  Antibody is detectable.  P24 is no longer detectable and HIV RNA levels come down.

This is exactly what happens almost always.  Nobody takes 3 months to make antibodies, it takes only a few weeks.  That's why a 6 week test is accurate in most cases.

Now the trick is that the "eclipse phase" can take longer, sometimes substantially longer.  This happens very rarely, but the evidence that it happens is pretty solid.  That of course bumps up the whole detection schedule as well.

That's why doctors recommend to wait the full three months for those with real exposure, just to rule out the rare case of a "delayed" infection course.  And that's why 6 weeks is usually sufficient for those whose chance of infection is minimal to begin with.  

Hope this helps all the WW out there

[j_worried]

Eclipse period is the duration of time whereby no test(PCR's, P24, antibody) can  yield a true positive result. This period however, does not last longer than 2-3 weeks max. It happens due to the fact that the virus does not get spilled over in the blood stream as it remains stuck in the tissue near the port of entry or the within the infected WBC's. All in all, 6 weeks indeed is very encouraging as once the virus reached blood stream, it hardly takes 4 weeks to get conclusive result. However, 12 weeks test gives you official clearance to park your car again.

[regularjoey]

you are exactly right

[regularjoey]

Thanks )

Forgot to add:

That's why if you are testing negative 3-4 weeks after the onset of your "ARS" symptoms, those symptoms can not possibly be due to HIV ARS.  Antibodies always get produced 2-3 weeks MAX after infection goes systemic.

[xworriedx]

You are exactly right, finally someone else who knows what their talking about.

[Teak]

Antibody product start producing but until there are enough for the test to detect is mean a negative result, which would be a false negative result.

[Teak]

So you want to think that you are smarter than the manufactures of the HIV tests? Did you happen to go to there sites and read? Apparently you didn't. What is your background in HIV. Are you like xworriedx, that doesn't have a background?

[regularjoey]

1. Modern tests pick up very low titers of antibodies.  The issue of "the amount of antibodies" isn't really an issue anymore, I think.
2. I read the one link you posted, but didn't really see anything new or interesting there.  You wouldn't expect anyone to put on the box the whole HIV textbook or even the extended post that I wrote above.  So they write what they write "if you test before three months you may get a false negative".  That's quick and simple for all to understand.
Besides, if you read my post, I don't disagree with the recommendations at all.  A test beyond three months is good to make sure you're not one of the outliers, where HIV takes an unusually long time to get to the bloodstream.  But if the odds you got HIV are one-in-a-million even before you take the test, who cares about outliers?
3. My background is extensive, that's all I will say here.  I make it my business to know everything about HIV.  The rules of the forum prohibit giving any personal information, so don't even try to fish it out of me.

[Teak]

There are no rules of the such, on this website. There is no rule limiting you about divulging your background in HIV.

[xworriedx]

If you can't admit that for 99% of people testing with modern HIV testing it will pick it up at 6 weeks then it is quite clear that you are the one who has no idea about HIV testing.

Its a fact that at 6 weeks 99% of people tested will pick up HIV. PERIOD.

[Teak]

Where are you getting that information to post? You are not getting it from the people that manufacture the tests. Take the time to read what the manufactures say about a Negative test.

[xworriedx]

Get a life loser.

[ScaredinAbuDhabi]

As posted before on this very site NY State Position:  



How soon after exposure can HIV infection be detected?
With the HIV antibody tests used in New York State, virtually all people who are infected will test positive within one month of being infected. Most people will test positive even sooner.

http://www.health.state.ny.us/diseases/aids/facts/questions/testing.htm

I am just as scared as the rest; though Teak is technically correct, info like the above gives me a warm fuzzy about my 8 week test.

[Teak]

You left out this portion from there website.

So, if you HIV antibody test is negative, you can be sure that you do not have HIV only if you have not engaged in any HIV risk behaviors (such as having unprotected sex or sharing needles) during the past three months.

[dumbo]

Teak is NOT an expert in HIV.  Period.  If he has claimed to be show me where and I will show it to medhelp, who has made this clear before for teak that he is not an expert here.  Only Dr. H is.  

Listen to "true" experts who say the 6 week mark for testing is very solid.  The only reason 3 months remain as "conclusive" is because the CDC is ultra conservative and has not changed yet.   Do not listen to some random internet poster who simply has the disease and was a paramedic.  That means nothing.

Even at aidsmeds they say almost all will infected people will test positive within 6 weeks, and all but the RAREST will do so within 3 months.  They of course stick to the 3 month mark as being "conclusive" simply for butt covering.  There are many mods there who state they have never seen someone test positive after a 6 week test, just like Dr. H (and many experts) have said time and time again.

The ONLY one I have EVER seen that says he sees it all the time is teak.  He also was also infected by a "bone laceration" (not by receptive anal), showed no symptoms, and is a long term non progressor, sees many people convert out to 3 months, you get the picture.  A book should be written on someone who has beaten every single odd regarding hiv.....seems odd, doesn't it? lol

Dr. H is not afraid to tell it like it is, yet people do not want to hear it.  They only want to hear fear such as teak happily provides.

[xworriedx]

Amen

[OCguy]

Thanks Teak and CJPlus for your posts on this thread.  Very straightforward.  If only there were a sticky system in this forum, I would imagine this would be a good candidate for that and less people would ask the same questions.

[neveragain131820]

I was looking for the CDC post that showed 99% accuracy at 6 weeks. I can swear I found it before... but now can't.

Does anyone have a link?

Thanks!

[davidk81]

The New York Department of health states that most people will test positive within one month.  

39. How soon after exposure can HIV infection be detected?
With the HIV antibody tests used in New York State, virtually all people who are
infected will test positive within one month of being infected. Most people will
test positive even sooner.
The period between the time of infection and the time that a HIV antibody test
can detect the infection is called the window period. During the window period, an
infected person does have HIV and can pass HIV to other people, even if his or
her HIV antibody test is negative.
So, if your HIV antibody test is negative, you can be sure that you do not have
HIV only if you have not engaged in any HIV risk behaviors (such as having
unprotected sex or sharing needles) during the past three months (see question 9).
A PCR (Polymerase Chain Reaction) test looks for HIV directly instead of
detecting antibodies. This test can fi nd HIV infection as soon as the person is
infected. It is usually used to fi nd HIV infection in newborns. A different type
of PCR test, called a viral load test, is used to measure the amount of HIV in the
blood of someone who is already known to be infected. Doctors may suggest an
HIV PCR test if they think a person has been infected with HIV in the past few
days or weeks (see question 65).

http://www.health.state.ny.us/diseases/aids/facts/questions/docs/100questions.pdf

[davidk81]

No, it's recommended that you get tested in 3 months but virtually everyone that is going to test positive after an exposure will test positive within one month.  I've tested negative out to 11 weeks after risky business.  I've came down with all of the symptoms and had a false positive at 2 weeks.  I'm convinced that I'm infected but there is a chance that I'm not.  I'm trusting in doctors and experts that have told me that hiv is not my problem.  

I tested negative at 8 weeks at roosevelt hospital and even describing to him what I've been through with symptoms and my risky behaviour.  The Senior Social worker there told me that I don't ever need to test again unless I want to put my mind at ease.  This is coming from one of the top aids clinics in NYC/NYS.  The population is so high and even till this day, he has never seen anyone test positive after testing negative at even 6 weeks.  Just remember that people get tested at 3 months and 6 months because of there own personal concerns.  CDC recommends that you trust in your testing instructor or your physician.  Me personally, I'm not taking any chances.  I'm going to test at 12 and 13 weeks along with 4 months and 6 months.  The chances of me having HIV as far as NYS is concerned is 0.  I'll figure out if this whole thing is bs if I test positive and will let everyone know.  But until then, I need to TRUST was professionals are telling me in order for me to maintain my sanity.

p.s.  If anyone that has symptoms after a sexual experience should also test for all other stds including hep b & hep c.

[remorse]

I don't think there is a chart that show 99% 6 weeks in CDC. Maybe you saw it in heallingwell forum?

[davidk81]

NO NO NO. I'm talking about the New York State Department of Health.

[stupid_717]

can you share your results from 6months test? thanks

[Teak]

Look at the dates of the threads before you post a question to a thread.