Aa
Hiv testing in Aus
Hello Dr
I know I only get 2 questions every 6 months so this will be my last. Thank you in advance.
As from my last post you said that there was no reason or testing. I started to have a sore throat from about day 12 and persists until today I am at nearly 5.5 weeks. It is not really sore like I have the flu it is more like there is somehting caught in my throat and is uncomfortable.
So on day 30 I decided that I should get tested due to the sore throat. There is skin peeling on my hands aswell I am not to sure it this is a early symptom. I have not had a rash or fever and doctor could not see anything wrong with my throat and said it could just be from acid reflux due to stress.
The test I took obviously is in Australia.
It says
Test type (Hir-o non commercial)
HIV 1 and 2 Ab/ag Negative
Quesions
1)Is this a 4th generation test?
2)Is this a duo that would be classed as conclusive at 30 days?
3)At the botom of my results it says that If test was taken within 3 months of exposure repeat test should be taken at 12 weeks. Do I need to follow this or is this following the CDC guidlines from older testing?
4) I undertand that symptoms are not a good indicator but from what I describe as symptoms (sore throat, peeling skin on hands) Do these sound like ARS symptoms?
5)Can I have sex with my wife without a condom?
6) Bottom line do I have HIV?
I know I only get 2 questions every 6 months so this will be my last. Thank you in advance.
As from my last post you said that there was no reason or testing. I started to have a sore throat from about day 12 and persists until today I am at nearly 5.5 weeks. It is not really sore like I have the flu it is more like there is somehting caught in my throat and is uncomfortable.
So on day 30 I decided that I should get tested due to the sore throat. There is skin peeling on my hands aswell I am not to sure it this is a early symptom. I have not had a rash or fever and doctor could not see anything wrong with my throat and said it could just be from acid reflux due to stress.
The test I took obviously is in Australia.
It says
Test type (Hir-o non commercial)
HIV 1 and 2 Ab/ag Negative
Quesions
1)Is this a 4th generation test?
2)Is this a duo that would be classed as conclusive at 30 days?
3)At the botom of my results it says that If test was taken within 3 months of exposure repeat test should be taken at 12 weeks. Do I need to follow this or is this following the CDC guidlines from older testing?
4) I undertand that symptoms are not a good indicator but from what I describe as symptoms (sore throat, peeling skin on hands) Do these sound like ARS symptoms?
5)Can I have sex with my wife without a condom?
6) Bottom line do I have HIV?
MEDICAL PROFESSIONAL
"They still ask for a follow up 12 week test. Dont understand why personally but this is the literature." This is explained in the thread I linked above. Because it is a regulatory issue, it is not likely to change in the near future. I don't see any need to "inform the community" beyond the currently available information.
Otherwise I have no further comment. That definitely will be all for this thread.
Otherwise I have no further comment. That definitely will be all for this thread.
Hi Dr
Hope you do not mind me posting it here but I have probably read that many posts where Australian's could not determin the window period for our tests. Here are the current requirements that the labs must follow. Even though they say the window period is 3-5 weeks for 3rd and 4th generation testing. They still ask for a follow up 12 week test. Dont understand why personally but this is the literature.
NATIONAL PATHOLOGY ACCREDITATION ADVISORY COUNCIL (NPAAC)
Requirements for laboratory testing for HIV and HCV (2nd edition 2009)
Seroconversion and window periods. Anti-HIV tests are presently available as
third and fourth generation tests. Fourth generation tests include the facility to
identify both antigen and antibody.
The window period or time between infection and when a test’s target analyte(s)
can first be detected, varies from test to test. The window period for third and
fourth generation anti-HIV tests is 3-5 weeks after infection. For qualitative NAT
the window period is approximately 2 weeks.
For anti-HCV tests the window period is 9-11 weeks. For combination tests the
window period is approximately 6 weeks and for qualitative NAT the average is
3 weeks.
If an individual is suspected to be at risk for seroconversion and the first test
result is negative or equivocal, a reporting comment should be included
suggesting testing should be performed again on a sample drawn 1-2 weeks
following the first sample for HIV and after 3-12 weeks for HCV depending on
when the exposure occurred relative to the first test. If there is no change, testing
should be performed again at 12 weeks after the exposure for HIV and in
approximately 24 weeks for HCV where the chance of conversion is 3 SD outside
the mean seroconversion time (or the chance of seroconversion is less than 1%).
I could go on and show so many more Australian expert opinions on window periods that I have found. That completely agree with the doctors on this forum.
The best is probably from Dr Darren Russell. He is the President of the Australasian Chapter of Sexual Health Medicine, and is a past President of the Australian Federation of AIDS Organisations.
He states in one of his documents.
The so called 4th generation test is available.
Previously the 3rd generation test where available in Australia.
Many places in America still use the old 2nd generation testing.
The 4th Generation ELISA tests use a anibody antigen sandwich.
The effect is to greatly reduce the window period before the test becomes positive.
The previous window period was 3 months.
With 3rd generation tests this is more like 4-6 weeks
With 4th Generation tests it could be as little as 2 weeks.
This change will have implications on the window period and detecting seroconversions.
How do we inform the community??
Hope you do not mind me posting it here but I have probably read that many posts where Australian's could not determin the window period for our tests. Here are the current requirements that the labs must follow. Even though they say the window period is 3-5 weeks for 3rd and 4th generation testing. They still ask for a follow up 12 week test. Dont understand why personally but this is the literature.
NATIONAL PATHOLOGY ACCREDITATION ADVISORY COUNCIL (NPAAC)
Requirements for laboratory testing for HIV and HCV (2nd edition 2009)
Seroconversion and window periods. Anti-HIV tests are presently available as
third and fourth generation tests. Fourth generation tests include the facility to
identify both antigen and antibody.
The window period or time between infection and when a test’s target analyte(s)
can first be detected, varies from test to test. The window period for third and
fourth generation anti-HIV tests is 3-5 weeks after infection. For qualitative NAT
the window period is approximately 2 weeks.
For anti-HCV tests the window period is 9-11 weeks. For combination tests the
window period is approximately 6 weeks and for qualitative NAT the average is
3 weeks.
If an individual is suspected to be at risk for seroconversion and the first test
result is negative or equivocal, a reporting comment should be included
suggesting testing should be performed again on a sample drawn 1-2 weeks
following the first sample for HIV and after 3-12 weeks for HCV depending on
when the exposure occurred relative to the first test. If there is no change, testing
should be performed again at 12 weeks after the exposure for HIV and in
approximately 24 weeks for HCV where the chance of conversion is 3 SD outside
the mean seroconversion time (or the chance of seroconversion is less than 1%).
I could go on and show so many more Australian expert opinions on window periods that I have found. That completely agree with the doctors on this forum.
The best is probably from Dr Darren Russell. He is the President of the Australasian Chapter of Sexual Health Medicine, and is a past President of the Australian Federation of AIDS Organisations.
He states in one of his documents.
The so called 4th generation test is available.
Previously the 3rd generation test where available in Australia.
Many places in America still use the old 2nd generation testing.
The 4th Generation ELISA tests use a anibody antigen sandwich.
The effect is to greatly reduce the window period before the test becomes positive.
The previous window period was 3 months.
With 3rd generation tests this is more like 4-6 weeks
With 4th Generation tests it could be as little as 2 weeks.
This change will have implications on the window period and detecting seroconversions.
How do we inform the community??
MEDICAL PROFESSIONAL
Chalk it up to a learning experience. In the country with the world's best STD/HIV clinical services through its network of sexual health centres, Australians with STD/HIV worries should take advantage of the world class care available in their local SHCs.
Cheers Doctor.
I really wish that the local GP did not send me out thiking that I had another 6 months to wait. You wan to be able to trust a GP on all aspects on health but it is so hard when there is a internet and search engine that quickly identifies his mistakes.
Thank you
That will be all for me time to start living life. YeeeHaaa
I really wish that the local GP did not send me out thiking that I had another 6 months to wait. You wan to be able to trust a GP on all aspects on health but it is so hard when there is a internet and search engine that quickly identifies his mistakes.
Thank you
That will be all for me time to start living life. YeeeHaaa
MEDICAL PROFESSIONAL
OK, I guess that's right. I missed the Ag part. So a definitive result, definitely no need for ther testing.
That should end this thread. Please try to move on and put this whole business out of your mind.
That should end this thread. Please try to move on and put this whole business out of your mind.
Sorry doc not trying to change the scenario just trying to get my facts straight.
(Ab) being antibody and (Ag) being antigen. SO therefore it was a 4th gen is this correct?
It is so hard with the literature and my local GP's very poor knowledge he tod me I had to wait another 6 months.
Thank you
(Ab) being antibody and (Ag) being antigen. SO therefore it was a 4th gen is this correct?
It is so hard with the literature and my local GP's very poor knowledge he tod me I had to wait another 6 months.
Thank you
MEDICAL PROFESSIONAL
I'm not going to waste any words on explaining again why this was a zero risk exposure that did not warrant HIV testing except for reassurance. Directly to your questions:
1,2) It was a third generation antibody test. 4th generation tests are third gen antibody tests combined with p24 antigen test. (Wherever you were tested could have told you.)
3) Even if there was significant risk -- as discussed, there was not -- the negative result you have had is highly reliable. 3 months is a standard recommendation, but is rarely necessary. Here is a thread that explains the discrepancy: http://www.medhelp.org/posts/HIV-Prevention/-A-Question-on-Testing/show/1347755 (read it all; the key information is in a follow-up comment).
4) No, those symptoms do not suggest HIV.
5) Yes. If I had been in your situation, I would never have stopped having unprotected sex with my wife.
6) No, you do not have HIV.
Let's dispense with follow-up comments. There is no scenario you can think up that would change my opinion or advice.
HHH, MD
1,2) It was a third generation antibody test. 4th generation tests are third gen antibody tests combined with p24 antigen test. (Wherever you were tested could have told you.)
3) Even if there was significant risk -- as discussed, there was not -- the negative result you have had is highly reliable. 3 months is a standard recommendation, but is rarely necessary. Here is a thread that explains the discrepancy: http://www.medhelp.org/posts/HIV-Prevention/-A-Question-on-Testing/show/1347755 (read it all; the key information is in a follow-up comment).
4) No, those symptoms do not suggest HIV.
5) Yes. If I had been in your situation, I would never have stopped having unprotected sex with my wife.
6) No, you do not have HIV.
Let's dispense with follow-up comments. There is no scenario you can think up that would change my opinion or advice.
HHH, MD
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