ELFA HIV tests and Diabetes impact on testing - Dr. HHH/Dr EWH

[hivedoff]

Dear, Doc: Greetings!

I posted in Jan 09.

I took a single test at 14 weeks, non reactive. But, I am not clear about the ELFA HIV method.

History and Facts:

I took an HIV test (ELFA).
Negative for HIV 1/ 2 at nearly 14 weeks (96 days).
My report read “HIV 1 & 2 (ELFA): Non Reactive" - No values.
Complete blood and STD tests on 30 March 2009 - All negative or normal.
Noticing diabetic symptoms since April 2009 - yet to be tested for diabetes.

Timelines:

Exposure - Nov 22 2008
HIV Test - Feb 25 2009 (Non reactive)
Blood and STD Tests - Mar 30 2009 (Normal or Negative)
Diabetes symptoms - April 2009

Understanding posts on the forum :

ELFA: Another method like ELISA but tests for antigens and antibodies.The window period for a conclusive HIV test irrespective of generation or method is 3 months. As the ELFA is not approved in the US but approved in other countries. Should I be concerned about this?

Diabetes: "No medical conditions and no medicine delay HIV sero conversion; diabetes certainly does not do so. (Advanced immune deficiency of the sort that occurs in terminal cancer might delay sero conversion, but even that is theoretical, without known actual cases.)".

The 6 month window period is for immune compromised individuals, does this include diabetics too?

Questions:

1. Are there any significant differences between ELFA and ELISA HIV testing?
2. Should I have specifically asked for an ELISA to test again?
3. Is my understanding that diabetes does not influence the results, correct?  
4. Did my results show a false negative in Feb 2009 if I had diabetes?
5. Will diabetes cause a late seroconversion if I re-test now? Should I?
6. Can I take my result with/without diabetic symptom as a conclusive negative?
7. What is your opinion about HIV care and testing in India? Is it on par or below industrialized nations?  

Thank you very much for your responses. Looking forward to your reply.

Wishes,
HivedOff

[Edward W Hook, MD]

Straight to your questions.  I am not familiar with an ELFA HIV test and thus cannot directly compare it to the stand ELISA assay.  If the test is liscensed for use by the US FDA or the EU, it is reliable.  If it is not or you do not know and are concerned, then you should get re-tested with a test you are assured is reliable.  The odds of infection from a single exposure to a partner of unknown HIV status however is very low.  Thus, even without testing, your risk for HIV from a single exposure is very, very low.

As for you questions:

1.  See above.
2.  Whther you ask for an ELISA or accept the ELFA depends on where it is liscened for use.  This is your decision.
3.  Diabetes has no effect on HIV test performance, risk for HIV, or HIV antibody production.
4.  No, the test would be reliable and not influenced by diabetes.
5.  No, diabetes does not cause late seroconversion
6.  Probably.  See above comments about test perfromance.
7.  It is excellent.

Hope these comments help.  EWH

[hivedoff]

Dear, Dr:

I checked with the Chief Microbiologist and Head of Diagnostics at the hospital where I was tested. I asked whether ELFA imethod uses the standard ELISA assay.

I was told that apart from the standard ELISA assay it uses for testing, it goes a step further to verify the results through a final fluorescence reading while the ELISA result is by way of a colorometric output.

Do you still feel that an ELISA and ELFA have any difference? Do I need to test again?

Cheers,
Hivedoff

[Edward W Hook, MD]

FRom what you tell me it looks as though the performance of the ELFA and ELISA should be the same but, as I said, I am unfamiliar with this test.  Your have the advantage of having spoken with the microbioligist who runs the lab.  EWH