Uncertainty in the Window Period...

I've been a frequent reader of this forum since my possible exposure to HIV in July of 2011. The stories, advice, etc. have kept me sane throughout this entire ordeal. I've taken many tests including most recent tests at 6 and 8 months post exposure and I'm planning to take another one at 11months post exposure... Why? Two reasons (1) I continue to have some oral, gastro, and other odd symptoms including what I think is Neuropathy. (2) Becuase the uncertainty of the window period in the medical community. Doctors on here say 8 weeks is enough, but not all Doctors or HIV specialists follow this. Others say 12 Weeks (3 Months), some say 6 Months, and a few say 1 Year or longer!  And to add to this confusion there have been studies and testimonies of people who turn positive way beyond 1 year after their exposure! Don't believe me? The following links will support this - copy and paste them in your browser.

Follow this link to study that was conducted by the Northwestern University Medical School: http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=2512827&dopt=Abstract

For those who argue that the above study is old. Follow this link to a testmonial of a persion had delayed seroconversion in 2000: http://www.****.com/Forums/AIDS/Labs/Q8096.html

What are your opinions on everything i stated above? This question is open to everybody. Let's have a good discussion.

[kanrevan]

3. generation Elisa test reliable on 3. months.

[kanrevan]

Junio99
i am member of the medhelp and forums.poz since 2007 and i never see someone  tested 3 mohnts negative and after  4-5-6- months pozitive .

regards

[nursegirl6572]

This is an excellent explanation as to the differing stances on the window period, written by MedHelp's Expert HIV Doctor, Dr. Handsfield:



Welcome to the forum and thanks for your question. I'll try to help.  Thanks for an opportunity to clarify (again) a very common question on this forum.  I'm taking the opportunity for a blog-like response that I can use in response to future questions.

The confusion about seroconversion time (window period) comes from three main sources.

First, failure to understand that not all HIV tests are the same.  Older antibody tests took longer than current ones, but not all web sites or public health agencies have caught up with the difference.  Also, testing often now includes direct tests for the virus, such as PCR for HIV DNA and tests for p24 antigen.  For the combination of such a test plus antibody testing (e.g., the "4th generation", "duo", or "combi" test), the window period is only 4 weeks.  By that time, all infected people will have a positive result on one or both components of the two tests.

Second, legal conservatism.  Some agencies lean over backward to take no chance of telling someone they don't have HIV if they may be infected.  Their legal departments advise going even further than scientifically necessary in their advice about window periods.  That's where you may see advice about 6 months, even though all antibody test manufacturers claim their tests are 100% reliable by 3 months.

Third, regulatory issues.  A company producing a new HIV test may validate it by studying blood from a few thousand persons, of whom some are known to have HIV and others are known not be infected.  For those with HIV, the company's research team may decide to only study persons with infection known to be present 3 months or more.  The test may in fact detect everyone infected for 6 weeks or even less.  But since they have only studied those infected for 3 months or more, the US Food and Drug Administration (FDA) requires them to say a negative result may not be reliable until 3 months have passed.

For the antibody tests, the last issue is the most confusing.  Everything known about the speed with which antibody develops in response to a new HIV infection, and the ability of the tests to detect that antibody, indicate that the tests will pick up virtually all new infections by 6 weeks, and certainly by 8 weeks.  But because of the regulatory standards, the manufacturer may not claim 100% reliability until 3 months.  And given the manufacturers' stance, it's easy to understand why physicians, clinics, health departments, or other agencies feel they need to stick with 3 months in their formal advice.

I hope this helps clarify these issues.  For more information, see these threads as well (read them all -- the main information is in the follow-up comments).

http://www.medhelp.org/posts/show/1347755
http://www.medhelp.org/posts/show/1177982

Best regards--   HHH, MD

[Junio99]

I've seen that explanation and it makes sense. But did you see the two links I've posted above? The explanation you posted discusses 6 Weeks and 3 months... but the links i posted have REAL cases of poeple who seroconverted... not at 6 Weeks... Not 3 Months... but YEARS!  Many of you are stuck in this forum and dont see beoynd it. There is so much information out there! No one truly knows when people seroconverts...

[Junio99]

This thread is going to recieve little posts becuase noone can dispute what I posted. I cited sources to support my argument.

[nursegirl6572]

You can find any information on the internet, it doesn't mean it is true.

Anyone can claim anything on the web, and as for the study you quoted, it is impossible to come to any conclusions based on the small amount of info provided in the absract.  You would have to be able to view the study in it's entirety to be able to better understand everything related to that study, which I was unable to find.

If you want to believe in delayed seroconversion (which none of us, nor the doctors on this site, who have literally DECADES of experience treating HIV patients have EVER seen or heard of a convincing case), then go ahead, and keep testing for years.  If you become positive, then feel free to come back and share your story.

[nursegirl6572]

Also, you have received many detailed answers and explanations from Dr. HHH, which you accepted.  

There's nothing else any of us are going to be able to convince you of, if you are so quick to disregard the advice of someone like Dr. HHH, who is an esteemed physician specializing in the assessment and treatment of HIV.

[Junio99]

Well, the reason its hard for me to be convinced is becuase I've cited sources that prove that the 'window period' of 8-12 weeks is total BS. Sorry to put it like that, but it is. A person who is exposed to HIV will not know its true status within weeks, its more like months and probaly years. And i'm NOT making this stuff up! I cited a study and a testimonial....

[Junio99]

Well, the reason its hard for me to be convinced is becuase I've cited sources that prove that the 'window period' of 8-12 weeks is total BS. Sorry to put it like that, but it is. A person who is exposed to HIV will not know its true status within weeks, its more like months and probaly years. And i'm NOT making this stuff up! I cited a study and a testimonial....

[joggen]

Isolated reports on forums are not scientific evidence. Even when they appear in peer-reviewed journals they are the weakest of scientific evidence. If you chose to believe those reports over the body of scientific evidence that the window period is three months, which the FDA, CDC, and international health agencies all agree on, then that is your right. But don't claim that your evidence is scientific- it isn't. Anybody can claim anything they want as an anonymous internet poster.

[nursegirl6572]

Joggen is 100% right.

So, you think ONE study (where only a small portion of info is posted with not enough info to assess anything!!!) trumps the advice of the doctor?  If that's what you care to believe, that's your opinion, but we're not going to discuss it.

We happen to believe what the experts, the fda, the cdc, have to say.