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Test validity for rare strains
Dear Doctors,
Hello, and thank you for your support on this forum. I have a peculiar concern, and I would like you to assess my personal situation rather than trying to gather information from the archives, as my case is unique.
I was stuck with a contaminated needle just over 6 months ago, which I believe to have been infected with HIV and Hepatitis C positive blood. During the following weeks, I did experience a number of symptoms, however not exactly your typical ARS. I lost a bit of weight, between 5 and 10 pounds, although I was eating and exercising well (Im not overweight). I also experienced nausea when I ate for just over a week, something that is very unusual for me. I also began to have muscle spasms very often, another thing that I do not normally experience. I have been so worried that I have been infected, however I have had 4 negative HIV 1/2 antibody w/ reflex tests, out through 6 months. I have also had 2 negative hepatitis c antibody tests out through 6 months. My doctor tells me this is conclusive, but he is no HIV expert. Here is my concern:
I strongly believe that my needle could have been contaminated with the rare group, group O. I know that it is not common at all, and I am sure that you get a lot of people concerned about this sort of thing, but I really believe that there is a very high possibility in my case. My question to you is: do standard, 3rd generation ELISA tests for HIV 1/2 pick up ALL strains of group O? I have heard different opinions, some people thinking that it would, and some people suggesting not. I have read that this test would detect MOST group O infections, but may miss some. I know the genetic makeup of group O is different than group M. So please offer your expert opinion, do I need a more specific test designed to specifically detect group O to completely rule it out? Maybe PCR? Or are my tests sufficient? Your advice would be greatly appreciated as I would like to resume a normal sex life. Thanks
Hello, and thank you for your support on this forum. I have a peculiar concern, and I would like you to assess my personal situation rather than trying to gather information from the archives, as my case is unique.
I was stuck with a contaminated needle just over 6 months ago, which I believe to have been infected with HIV and Hepatitis C positive blood. During the following weeks, I did experience a number of symptoms, however not exactly your typical ARS. I lost a bit of weight, between 5 and 10 pounds, although I was eating and exercising well (Im not overweight). I also experienced nausea when I ate for just over a week, something that is very unusual for me. I also began to have muscle spasms very often, another thing that I do not normally experience. I have been so worried that I have been infected, however I have had 4 negative HIV 1/2 antibody w/ reflex tests, out through 6 months. I have also had 2 negative hepatitis c antibody tests out through 6 months. My doctor tells me this is conclusive, but he is no HIV expert. Here is my concern:
I strongly believe that my needle could have been contaminated with the rare group, group O. I know that it is not common at all, and I am sure that you get a lot of people concerned about this sort of thing, but I really believe that there is a very high possibility in my case. My question to you is: do standard, 3rd generation ELISA tests for HIV 1/2 pick up ALL strains of group O? I have heard different opinions, some people thinking that it would, and some people suggesting not. I have read that this test would detect MOST group O infections, but may miss some. I know the genetic makeup of group O is different than group M. So please offer your expert opinion, do I need a more specific test designed to specifically detect group O to completely rule it out? Maybe PCR? Or are my tests sufficient? Your advice would be greatly appreciated as I would like to resume a normal sex life. Thanks
Thank you for your response Dr. Sean. It makes perfect sense, I now realize that my question is impossible to know for certain, thanks for giving your opinion. I know that I stated that that would be my last question, and your advice has been helpful, however I do have one final question... It will undoubtedly be my last. If you can address this last one that would be great, and if not, I understand and thank you for your time.
I was just wondering about the Hepatitis C window period, sometimes I notice spasms which seem to come from my liver area and an unusual presence, if you will, of my abdomen region right around my liver. This concerns me of hepatitis c considering my exposure, so my last question is this: If one was coinfected with HIV and hepatitis c simultaneously, through one single exposure, would they produce antibodies to hep c within 6 months? Or is it a possibility that due to recently acquired HIV, that antibody response to hepatitis c could be delayed beyond 6 months? Thank you so much, this one final opinion would be greatly appreciated. I also had normal liver function tests at the 3 month mark post exposure, I am not sure if this means anything in my situation or not
I was just wondering about the Hepatitis C window period, sometimes I notice spasms which seem to come from my liver area and an unusual presence, if you will, of my abdomen region right around my liver. This concerns me of hepatitis c considering my exposure, so my last question is this: If one was coinfected with HIV and hepatitis c simultaneously, through one single exposure, would they produce antibodies to hep c within 6 months? Or is it a possibility that due to recently acquired HIV, that antibody response to hepatitis c could be delayed beyond 6 months? Thank you so much, this one final opinion would be greatly appreciated. I also had normal liver function tests at the 3 month mark post exposure, I am not sure if this means anything in my situation or not
MEDICAL PROFESSIONAL
Hello
You are asking an impossible question - its a bit like an Alice in Wonderland riddle.
If there are strains which we don't know about, then obviously, we're not going to know whether we've missed them because we don't know they are there.
We believe on all currently available evidence that 1) we are able to detect all the strains that are currently around and 2) that there is some "cross detection" between strains so even if a new strain were to develop it is likely that it would have sufficent common factors to allow us to detect it.
Best wishes, Sean
You are asking an impossible question - its a bit like an Alice in Wonderland riddle.
If there are strains which we don't know about, then obviously, we're not going to know whether we've missed them because we don't know they are there.
We believe on all currently available evidence that 1) we are able to detect all the strains that are currently around and 2) that there is some "cross detection" between strains so even if a new strain were to develop it is likely that it would have sufficent common factors to allow us to detect it.
Best wishes, Sean
Please doctor, just one follow up question. Do the tests miss some of these rare strains? It is my understanding that group o and group n are significantly different in composition from the more common ones, but I was told by my doctor that the antibody tests that they do are approved by the fda, so I assume that they are some of the more advanced ones. Is it possible that my test could have missed a rare strain from one of these groups? My symptoms and matching symptoms from my partner right on cue have me worried, and my exposure was very high risk. Please offer your advice, this is my only follow up question i will ask
Hello doctors, please just respond to my one folluw up question: Do some strains get missed by HIV 1/2 ELISA? Would some strains of group O give a false negative antibody result? This is the real question that I wanted to know and is why I posted, for an expert opinion on this question. I know they are rare but I really need an answer to this question so I can take the next step from here. Thanks
Thank you for your assessment. I just have one more question, I will be more straightforward rather than having you assess my situation personally.
Does the HIV 1/2 ELISA pick up all strains of HIV? Is there any chance it could miss a strain that has significantly different genetic makeup than a more common strain? Thank you in advance
Does the HIV 1/2 ELISA pick up all strains of HIV? Is there any chance it could miss a strain that has significantly different genetic makeup than a more common strain? Thank you in advance
MEDICAL PROFESSIONAL
It sounds more like an assumption that you were stuck with an infected needle rather than a certainty. Either way it makes no difference and the tests are certain. The decision that the needle was infected sounds spurious and I think you have transferred your vivid imagination powers to the testing methods. Your doctor is correctt. You dont needt to test again. You are HIV negative. Merv
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