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Reliability of 6 week HIV test results
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Reliability of 6 week HIV test results

I'd like to start off by saying thank you very much to everyone and especially the dr HHH, on this forum. It has been a great source of support, reassurance and down-to-earth information.

I just got my negative results back today for my 6 week 3 day ELISA test (Thank God). This was a huge surprise to me as I have had every HIV symptom (excluding the rash), all right on cue.
I am not yet convinced there is nothing wrong, but I am relieved it is probably not HIV. I will do another test at the 12 week stage just to be sure.

I have read on the internet that it can take between 2-4 weeks, and sometimes even longer for primary HIV infection to occur and this can last for months (usually not).
I have also seen in this article (http://ww2.aegis.org/pubs/bala/1993/ba930810.html) that "Unfortunately, at the time of primary infection, patients are typically antibody negative".
So how does this relate to having tests at 6 weeks? Would this mean that, if PHI occurs late and lasts longer, the 6 week test could come back false negative?

It is conflicting information like this that has everyone worrying beyond reason.
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239123_tn?1267651214
I'm sorry, I simply cannot keep answering the same question in detail.  The range of time when antibody develops is 3 weeks to 3 months; extremely rarely it takes 4 or even 6 months.  Over 95% (probably closer to 99%) of people are positive within 6-8 weeks.  Part of the uncertainty relates to the fact that in most infected people it is impossible to know exactly when they were exposed,* and without that, any estimate of the time to postive test is difficult to calculate with certainty. In view of the uncertainty, many counseling agencies and websites use the more conservative (longer) figures when they counsel people, partly a legally driven CYA approach.  You can expect "conflicting information like this" to persiste forever; 20 years from now it will still be there.  Live with it.  For 99% of people tested it makes zero difference in interpretation or advice.

* This is because almost nobody like you, or like most of the people who post such questions on this forum, ever has a positive result.  People at low risk often know exactly when their supposedly risky event took place.  But the vast majority of new infections occur in people who have multiple, repeated risky exposures.  When they develop a positive test, they have no clue which exposure was the source of infection.  That makes it nearly impossible to have accurate data on time to seroconversion.

HHH, MD

8 Comments
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Avatar_n_tn
I bet Dr. H is so sick of our window and testing questions he is ready to choke somebody.

I think a person's body usually starts producing antibodies before the time of onset of symptoms. There just may not be enough to be detected yet. This is evident if you look at a graph plotting HIV viral load and antibodies versus time.

However, the new tests are better at detecting these low levels. And I think that it is not required to have symptoms for your body to start producing antibodies since some people never have symptoms. The key is that in the studies that have been done and people that are actually testing patients (like Dr. H) are proving a 6 weeks window time with tests, regardless of the time of symptoms and if they even occur.

This is my half *** HIV educated opinion on what is going on.
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Avatar_n_tn
Thanks Dr HHH.

I understand that stats like these are hard to gather and interpret.

However I'm now not as comfortable about my test result as I was this morning. My "comfort after test neg" window has now gone from 4-6 weeks to 6-8 weeks and "unlikely to test positive" window has gone from upto 3 month to 4-6 months.

I also understand that statistically what is considered low risk activities are alot more risky when your talking about your own life that when talking about someone else.

I need step back and look at the stats for what they are, no reassurance, no promise, just likelyhood.

Thanks again for the info, I will not post again.
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Avatar_n_tn
I sympathize with you, but it sort of reminds me of the line from the movie "Dumb and Dumber".  

Lloyd asks the girl if she would go out with him.  She exclaims that there is less than one in a million chance she would ever go out with him.  He responds by exclaiming hopefully, "So you're saying there's a CHANCE!!!"

If you aren't comfortable with what Dr. HHH told you, it is your own spin on it, messing with your mind. The facts are such that you don't need to be concerned now.

I think that you will not rest comfortably til 6 months has gone by.  In the meantime, if you have another sexual exposure, your internal comfort clock will reset again.  The result could be that you will be living with a constant fear of HIV.  I echo Dr. HHH's oft repeated advice that if you are excessively concerned about something despite the facts pointing to reassurance, some sort of psychological help may be warranted.
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239123_tn?1267651214
Even when you're talking about "your own life", a certain amount of rationality is required.  Follwing an exposure with 1 chance in 100,000 of acquiring HIV, a negative test with 95% reliability (e.g., 6 weeks) drops the odds HIV is present down to 1 chance in 2 million.  That's far less than the chance of dying from an accident or other sudden illness within the next week.

HHH, MD
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Avatar_n_tn
Since you did not have unprotected vaginal or anal sex and are not an IV drug users, you would be the only documented peron to get HIV from oral (do I remember your expouser right). Also the doc has never seen someone turn positive after a 6 week negative. Your odds are in range with something that has never happened in history. Perhaps 1 in billions. Do you worry about other things with those odds in your favor. Maybe you are going to get hit by a meteor tonight.
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Thank you everyone for your comments and support.
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A related discussion, HIV + Possibility was started.
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A related discussion, 6 weeks negative was started.
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A related discussion, HIV rapid test for antibodies was started.
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I had unprotected anal gay sex with an unkown HIV status person. I had an HIV rapid test at 6 to 7 weeks after possible exposure and test was negative but the doctor told me I need to wait 3 months after possible exposure to tell me I'm really negative. I'm scared because I also had dry cough, diareah, abdominal pain, a small rash on my chest and a really long herpes outbreak, can these symptoms be anxiety or HIV? And is my test reliable?
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A related discussion, doctor please help me..clear my doubts!! was started.
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