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TEAK - window period

I know you say 3 months is conclusive.  If this is truly the case, why do a lot of legitimate sites and experts still say 6 months.  Believe me, I want to know that my recent 3 month neg test result is conclusive, but the ID doc I visited said 6 mos is 100%.  Are there documented cases in recent years of someone taking longer than 3 mos?  Or, is the 6 mo window period still around because that was always the standard.  I recognize test are more sensitive than before, etc, etc.  

Like I said, I was tested the day after 3 months exactly and it was neg.  I had a RNA PCR at 2 & 9 weeks too.  Do you think there is any chance I would show antibodies at 4, 5, or 6 months?

THX
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Avatar universal
I read about a fella who tested positive for hiv he caught from his girlfriend who knowingly infected him as well as some others. You think that's bad? He found out he also had cancer within that same year!
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Avatar universal
I agree. Here I am with a 12 week negative and symptoms that I have NEVER had before. I keep thinking I could chalk it up to something else but there is nothing else on the STD list that has these symptoms but HIV. I am a rather healthy (other than smoking) 30 year old male with no chemo or IV user.

And when I say symptoms of HIV...I mean every one of them and right on time. How can I at all feel like 12 weeks is conclusive when there isn't any rational reason to have these other than HIV.

Honestly I would wait for the baby. My wife is pregnant right now. If I have this...she does to and you can only imagine the feeling of thinking I have an HIV+ baby.
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Avatar universal
but i can't find any good info on the reason some people take longer than 3 mos is from cancer treatment or drug use.  everyone on this forum says that but where are you getting info from?  how many people going through cancer treatment and fighting for their life are out performing high risk behaviors and putting themselves at risk of HIV.  I suppose this happens but seems a little unlikely.
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277836 tn?1359666174
because of iv drug users
cancer treatment patients     thats why
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Avatar universal
OCD, yup that's me for sure.  I can't disagree.  The main concern has always been the symptoms that I have never had before in my life.  My wife and I have discussed having another child and I'm scared to try until a 6 month test.  I think she is ready to move on but I am still struggling.

For those of you that don't know- I had a blood exposure at work.  My HCV antibody was neg at 3 mos too.

TEAK- I do appreciate your educated thoughts.  Can I just ask you how you are so sure 13 weeks is absolutely conclusive?  Is this based on recent research, studies, stats, etc.  I know you are well educated on this topic.  Why does the CDC 97% at 3 mos and 6 mos conclusive?
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Avatar universal
Yes, you are just rambling on and you are conclusively negative. Seek help with you OCD issues. You not going to find help with it on any forum.
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Avatar universal
I do appreciate everyone's encouraging thoughts.  Believe me, I want to move on with my life and celebrate.  One source says conclusive at 3 months, another says 97% (CDC) and others say 99%...clearly there are different opinions from different experts.  

I don't know why my body would all of sudden develop antibodies, especially with a negative viral load test at 15 days and 63 days but I would imagine it has happened.  Sometimes I do wonder if the people that test positive after 3 months received any viral load tests within that 3 month period.  I also wonder if they were exposed after 3 months and are dishonest.  There are a lot of factors to consider.  All I know is that I have received 4 antibody tests (2, 6, 9, and 13 weeks)...2 at Labcorp (ICMA) and 2 at Quest (EIA).  I would certainly hope I'm in the clear.  My viral loads were done at Labcorp...I'm assuming they use the most advanced technologies.  I know I'm just rambling on, but this has been the most miserable experience of my life and I have never been so stressed.  To top it off, I feel like weird symptoms keep popping up and it scares me.  I know stress and anxiety can create health issues too...I'm sure I need to chill out a little.
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Avatar universal
You receive a conclusive negative result at 3 months. PERIOD.
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Avatar universal
are tested wioth this rna testing so woo hoo now u all donated some blood
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Avatar universal
Narrowing the
Diagnostic Window:
Identifying Acute
HIV Infections
A Publication of Maryland’s State Public Health Laboratory
January 2008 Volume 12, Number 1
Acute Infections and HIV transmission
The initial phase of HIV disease is referred to as the acute
phase. After HIV enters the body it replicates to high levels until
host immune defenses are activated and reduce the initially high
viral burdens (viral loads) to lower chronic baseline levels that
persist for years. The duration of the acute phase is estimated to
range from 54 to 62 days 1,2 with viral loads spiking during the
first two to five weeks after acquisition of the infection.1,3,4,5 The
acute phase is not only characterized by high HIV viral loads in
the plasma (blood) but also by viral shedding from the genital
tract. Viral shedding in the genital tract has been associated with
higher rates of transmission per exposure than later phases of
infection.1,3 It has been estimated that nearly half of all HIV transmissions
can be attributed to acutely infected individuals who are
highly infectious and unaware of their disease status.3,6,7
(Continued on page 2)
Inside this issue:
Narrowing the Diagnostic Window:
Identifying Acute HIV Infections
GC Media Report
LABORATORY STATISTICS
Page 1
Page 1
Page 5
Gonococcus (GC)
Media Report
Over the past 20 months, the Laboratories Administration’s Public
Health Microbiology Division conducted investigations to determine
why there has been a significant increase in the number
of Neisseria gonorrhoeae cultures that are being reported out as
“unsatisfactory” (unsat) due to overgrowth by normal flora. During
this period, the local health departments (LHDs) have been
involved and worked with the State Laboratory in studying this
problem.
Beginning in April 2005, the Public Health Microbiology Division
reviewed and studied a number of possible causes and solutions.
These include comparing media from different manufacturers,
requesting and comparing reformulated media, and looking
into such variables as specimen collection errors, transport
temperature, delivery times, individual plating and incubating
procedures, and incubation times. While these variables accounted
for specific problems at certain times in particular clinics,
all were ruled out as the cause of the overgrowth problem
that was occurring across the State.
Various LHD clinics were asked in the past year to use a particular
type of culture system (i.e., TransgrowTM bottles, JembecTM
plates, and modified Thayer-Martin agar [MTM II] plates).
Between January 2005 and July 2007 TransgrowTM and JembecTM
plates were found in any given month to have overgrowth
rates as high as 18% and 7%, respectively. However, using
these media did not resolve the overgrowth problem. After 20
months of investigating this problem, and finding no smoking
gun, it appears that the normal flora from the throat, vagina,
rectum, and urethra of many clinic patients may simply be expressing
a naturally increased resistance to the antibiotics in GC
culture media.
Nevertheless, the studies have proved useful. They have allowed
the Public Health Microbiology Division to compile a list of
important tips for LHD clinics collecting and plating GC speci-
(Continued on page 4)
Vol. 12, No. 1 2 January 2008
Identifying Acute HIV Infections
For more than two decades HIV diagnostic testing primarily has
relied on the detection of HIV specific antibodies that are produced
as part of the host immune response to the infection.
However, using existing HIV screening tests, detectable levels
of HIV specific antibodies cannot be demonstrated in blood for
at least one to two weeks after HIV genetic material (RNA) can
be detected in the blood by nucleic acid amplification testing
(NAAT).2,10 Therefore HIV-1 NAAT has become the method of
choice to identify acute HIV-1 infections. The early stage of an
acute HIV infection is known as the "window phase.” The window
phase is characterized by high levels of HIV in the blood
(viremia) that can be detected by HIV-1 NAAT prior to the production
of HIV specific antibodies (seroconversion) by the
acutely infected individual. The duration of the window phase is
determined by the relative sensitivity of HIV antibody screening
(Enzyme Immuno-Assay: EIA or rapid point-of-care tests).
Newer, third-generation EIA’s based on recombinant or synthetic
peptide antigens generally can detect HIV specific antibodies
days or weeks earlier than EIA’s based on whole viral
lysate antigens that were originally developed in the 1980’s or
early 1990’s.9 Additionally, newer, third-generation EIA’s are
more sensitive than the traditional HIV-1 western blot confirmatory
assay and most of the rapid point-of-care screening tests.
Many third-generation EIA reactive specimens from acutely
HIV-1 infected individuals can be initially non-reactive in rapid
screening tests or, if reactive in newer generation screening
immunoassays, cannot be confirmed as HIV-1 antibody-positive
by less sensitive traditional western blot (WB) testing. This
effectively prolongs the time of the window phase until HIV-1
seroconversion can be confirmed.
HIV-1 NAAT of Blood Donors
Recognizing the importance of identifying acute HIV infections
to prevent transmission via HIV infected blood products, the
blood banking centers in the United States began using HIV-1
NAAT to screen pools of 16-24 HIV antibody negative specimens
in March 1999.11 If a pool is found to contain HIV RNA, it
is deconstructed and each specimen making up the pool is
tested individually to identify the specimen(s) from the acutely
infected donor(s). Pooling protocols allow fewer tests to be performed
per specimen and thus reduce the high cost of performing
HIV-1 NAAT when screening large numbers of specimens.
Due to the low prevalence of HIV infections in blood donors, the
identification of acute HIV infections by HIV-1 NAAT rarely occurs
in this population. On average, one acutely HIV-1 infected
donor is identified by HIV-1 NAAT for every 3.1 million donated
units tested.11
HIV-1 NAAT in Public Health Settings
Starting in North Carolina in 2002, state and local public health
laboratories began to utilize NAAT to identify acute HIV-1 infections
within their testing populations. Testing programs in
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Avatar universal
It may well be conclusive at 6 weeks they reckon it's at least 95% conclusive then but the official line is still 3 months so until that changes I think it's best to stick to the 3 months
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Avatar universal
I studied web, 12weeks is conclsive. And more HIV experts opinion is 6weeks conclusive for normal people(no drug, no cancer, no organism transplant). One of scientists is Mrs Chao , a Chinese woman, she worked at USA famous HIV reseach center and is chief scientest, She said 6weeks is conclusive.
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Avatar universal
If you test negative on ELISA, it means that your body did not produce yet the antibodies, then you should have very high viral load. Now if you have high viral load, then the PCR test will detect it easily. I think it makes a lot of sense. Also, I couldn't find a single reference to FALSE NEGATIVE PCR result. It does produce many FALSE POSITIVES, but not FALSE NEGATIVES.
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Avatar universal
I still have some symptoms too, but I am sure it is not HIV related. I have some itching/burning, have some cough (possibly cold or flu), but cmon, if we are negative on both tests - we are fine!
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Avatar universal
I tested NEG for both PCR and ELISA at 10.5 weeks, and I finally cooled down about my HIV worries. I've taken tests at the medical center that monitors Hollywood porn industry, and they told me that they've been testing industry from 1998, and with PCR tests never had even 1 false negative (28 days after exposure). I didn't believe them at first, and I still ordered both, ELISA and PCR, and both came out negative. I think if you have both PCR and ELISA neg at >6 weeks, you are fine.
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Avatar universal
also, i still have lingering symptoms.  at 10 wks i had awful stomach cramps for a week...no fever, etc.  and for the last 2 weeks i have had tingling in my hands and feet and mild itchy/burny sensations.  i'm not sure if my nerves have caused these symptoms from stress or if it is due to a virus.
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Avatar universal
in theory, this makes sense to me too.  however, when i had this discussion with Teak a few weeks ago after my neg viral load and antibody test he seem to disagree.

i wonder how i could all of a sudden test pos if 2 tests didn't show a viral load and there are no antibodies at 13 weeks.  yet, i'm sure this has happened to people and it was a total shocker.  
Helpful - 0
386032 tn?1220401438
the dr is right some people will have undetechable pcr rna but only after their body has squash the virus, so i would think no viral load you would have antibodies from the body squashing the virus.
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Avatar universal
how can you be sure?  hopefully i will not have another exposure.  i just want to let this go but i have lingering concerns.  
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Avatar universal
No you won't because as long as there has been no exposure inbetween you're negative.
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Avatar universal
My ID doc did also say that he thinks I'm neg because of the 2 & 9 wk viral load tests and to get life back to normal.  Yet, he contradicts himself by saying 6 mos is conclusive.  Teak has stated that the PCR RNA tests are not that useful because some people don't have detectable viral loads but are HIV pos.  I'm not sure if this is true during the acute HIV phase or later on once their body has controlled the virus.  I read so many different think regarding the viral load tests???  

I'm not an IV drug user, on any drugs that would inhibit antibody production, etc.  97% is good but I really need 100%.  I guess I'll have to wait 3 more mos
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386032 tn?1220401438
it would seem to me if you didnt have antibodies at 3 months , you would not have a neg pcr rna, your viral load would be high since there was nothing fighting the virus. i am pretty sure that is correct.
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Avatar universal
So you're a Doctor now? If you test out the 3 months that's it. What do you think's going to happen that it's going to change to positive after 10 years?
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Avatar universal
3 months is over 97% conclusive, it's not 100%, 6 months is not even 100%, theres ALWAYS a chance, its a matter of you being comfortable with yourself, which I also am not. The 3% of the 100% at the 3 month period usually have outstanding circumstances that cause them not to accurately test (cancer, drugs, etc.)
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