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research and window period
Congratulations for this site. I’ve been checking lots of threads. I tested negative close to the 9-week mark using oraquick finger stick. It was a relief (MSM exposure). However, I could read recent articles (2009-2011) published in recognized medical magazines (specially in Seattle-King County, San Francisco and NY).
In those papers, they conclude, basically, as to rapid tests or standard 2nd generation, that “window period” for recent infection (not acute) could be longer than they thought.
1)I am planning to test again in 13-week mark. Since I know you have been studying this subject for many years, I would like to hear your opinion. Do you think I need to test again?
2)Why are you so confident (and I hope you are right) while so many experts are a bit more cautious. I could not find one single study being so conclusive about window period (again, I hope you are right).
3)I read your (Dr. Handsfield) recommendation not to test by on line services. I was thinking in get tested through one of them (I got a CBC once through them). Actually, they are only a kind of “middleman” between client and Lab (LabCorp most times, at least in California). The test itself is done in LabCorp and the official result is showed with their hallmark. Is there problem on that?
In those papers, they conclude, basically, as to rapid tests or standard 2nd generation, that “window period” for recent infection (not acute) could be longer than they thought.
1)I am planning to test again in 13-week mark. Since I know you have been studying this subject for many years, I would like to hear your opinion. Do you think I need to test again?
2)Why are you so confident (and I hope you are right) while so many experts are a bit more cautious. I could not find one single study being so conclusive about window period (again, I hope you are right).
3)I read your (Dr. Handsfield) recommendation not to test by on line services. I was thinking in get tested through one of them (I got a CBC once through them). Actually, they are only a kind of “middleman” between client and Lab (LabCorp most times, at least in California). The test itself is done in LabCorp and the official result is showed with their hallmark. Is there problem on that?
MEDICAL PROFESSIONAL
1) Antibiotics do not "weaken the immune system". (Where did you get that idea??) And even if it did, this is irrelevant. Except for truly profound immune system dysfuction -- e.g. of the sort from potent chemotherapy or terminal illnesses -- there is no known effect on HIV results or seroconverion time.
2) As I said, "The...problem with rapid tests is not missing people with HIV infection, but a somewhat greater chance of false positive results -- which can be very upsetting while awaiting follow-up tests to show the patient didn't have HIV after all." Lab based tests avoid this risk.
3) The CBC is a nonspecific test. Many people with HIV have various CBC abnormalities, but many do not. CBC results are rarely if ever helpful in judging the likelihood someone has HIV.
4) I have not recently analyzed the published data and have neither the time nor interest in doing so now.
5) I'm not sure what you're getting at here. The fact is that these were sufficiently low risk exposures that, in and of themselves, do not warrant HIV testing. You're worrying about outcomes in the lightning strike probability range.
I suggest you stop over-analyzing, stop searching the internet, and accept that you are at minimal if any risk for HIV. Feel free to have whatever additional tests will help you get beyond your anxieties about it. But I stand by my judgment that you have nothing to worry about.
That's all for this thread. I won't have any more comments or advice.
2) As I said, "The...problem with rapid tests is not missing people with HIV infection, but a somewhat greater chance of false positive results -- which can be very upsetting while awaiting follow-up tests to show the patient didn't have HIV after all." Lab based tests avoid this risk.
3) The CBC is a nonspecific test. Many people with HIV have various CBC abnormalities, but many do not. CBC results are rarely if ever helpful in judging the likelihood someone has HIV.
4) I have not recently analyzed the published data and have neither the time nor interest in doing so now.
5) I'm not sure what you're getting at here. The fact is that these were sufficiently low risk exposures that, in and of themselves, do not warrant HIV testing. You're worrying about outcomes in the lightning strike probability range.
I suggest you stop over-analyzing, stop searching the internet, and accept that you are at minimal if any risk for HIV. Feel free to have whatever additional tests will help you get beyond your anxieties about it. But I stand by my judgment that you have nothing to worry about.
That's all for this thread. I won't have any more comments or advice.
Thanks. Only 5 more observations and you may please close the thread.
1)I know most experts say antibiotics do not affect the HIV result (I was taking it). But I dont understand why. If it weakens the immune system, theorically, it could affect (like others do).
2)Why did you suggest me, this time, a lab based test? Is it more reliable? Or less chance of a false positive?
3)May the CBC indicates any abnormalities in a recent (or acute) HIV infected person (platelets, wbc, lymphs etc.)? I mean, In your daily basis, do you usually see any abnormalities?
4)As to studies, I read your excelent article. I also read one (from Seattle) by Joanne Stekler (and others). I think you should already seen it. It is "Sensitivity of OraQuick and Early Generation Enzyme Immunoassay (EIA) within a Pooled HIV Nucleic Acid Amplification Testing (HIV NAAT) Program”. In it (a very large study), it is concluded that Oraquick missed recent infection (not acute). 10 weeks could be considered recent infection?
5)My exposure: oral sex and being fingered (with pre-cum on his fingers) with high-risk person (MSM). I know you all think masturbation is not a risk. I think you are right. But a finger with pre-cum is very similar to a penis with pre-cum. The trauma is, sometimes, the same (it bled in my situation). I know HIV does not "survive" outside the body, but this interval is only about 1-2 seconds.
Thanks
1)I know most experts say antibiotics do not affect the HIV result (I was taking it). But I dont understand why. If it weakens the immune system, theorically, it could affect (like others do).
2)Why did you suggest me, this time, a lab based test? Is it more reliable? Or less chance of a false positive?
3)May the CBC indicates any abnormalities in a recent (or acute) HIV infected person (platelets, wbc, lymphs etc.)? I mean, In your daily basis, do you usually see any abnormalities?
4)As to studies, I read your excelent article. I also read one (from Seattle) by Joanne Stekler (and others). I think you should already seen it. It is "Sensitivity of OraQuick and Early Generation Enzyme Immunoassay (EIA) within a Pooled HIV Nucleic Acid Amplification Testing (HIV NAAT) Program”. In it (a very large study), it is concluded that Oraquick missed recent infection (not acute). 10 weeks could be considered recent infection?
5)My exposure: oral sex and being fingered (with pre-cum on his fingers) with high-risk person (MSM). I know you all think masturbation is not a risk. I think you are right. But a finger with pre-cum is very similar to a penis with pre-cum. The trauma is, sometimes, the same (it bled in my situation). I know HIV does not "survive" outside the body, but this interval is only about 1-2 seconds.
Thanks
MEDICAL PROFESSIONAL
Welcome to the forum.
The research results you are concerned about have been discussed on this forum a number of times. They are not typical of most studies, and the large majority of experts agree the rapid tests have almost the same performance as the laboratory-based antibody tests. (And I speak as a co-author of one of the studies you refer to, the one from Seattle.) The bigger problem with rapid tests is not missing people with HIV infection, but a somewhat greater chance of false positive results -- which can be very upsetting while awaiting follow-up tests to show the patient didn't have HIV after all.
1) Negative results with the current antibody tests, including rapid tests, are 100% reliable (or very close to it) by 6-8 weeks. However, if your exposure was particularly high risk -- e.g. unprotected anal with a male partner who is HIV positive or with unknown status -- a 3 month (12-13 week) test is recommended by many experts. If you proceed, you can definitely expect negative results. This time I suggest you have a laboratory based blood test, not a rapid test.
2) Here are two threads that explain our positions on HIV test reliability: http://www.medhelp.org/posts/HIV-Prevention/-A-Question-on-Testing/show/1347755
http://www.medhelp.org/posts/HIV-Prevention/Need-your-help/show/1345664
3) Online testing services have their place, and in fact I recommend them strongly in some circumstances. (I'm well aware they serve only as agents for indepedent labs, like LabCorp or Quest.) Such testing is often a good option for someone who has been sexually active in general, but has no symptoms. However, if someone has a specific exposure they are concerned about, or if they have symptoms, it's often best to see a health professional in person. Professional advice by an expert can put all the information into context -- the nature of the exposure, the symptoms, etc -- and can better advice a) which tests to have and b) how to interpret the test results in light of all the available information. In addition, many online testing services take advantage of patients' anxieties by encouraging (or not discouraging) many tests that may not be necessary, often at great expense.
In your case, it seems you have an objective slant, and you're dealing with HIV testing only, not an extensive "STI panel" of multiple tests. I have no problem with it.
Regards-- HHH, MD
The research results you are concerned about have been discussed on this forum a number of times. They are not typical of most studies, and the large majority of experts agree the rapid tests have almost the same performance as the laboratory-based antibody tests. (And I speak as a co-author of one of the studies you refer to, the one from Seattle.) The bigger problem with rapid tests is not missing people with HIV infection, but a somewhat greater chance of false positive results -- which can be very upsetting while awaiting follow-up tests to show the patient didn't have HIV after all.
1) Negative results with the current antibody tests, including rapid tests, are 100% reliable (or very close to it) by 6-8 weeks. However, if your exposure was particularly high risk -- e.g. unprotected anal with a male partner who is HIV positive or with unknown status -- a 3 month (12-13 week) test is recommended by many experts. If you proceed, you can definitely expect negative results. This time I suggest you have a laboratory based blood test, not a rapid test.
2) Here are two threads that explain our positions on HIV test reliability: http://www.medhelp.org/posts/HIV-Prevention/-A-Question-on-Testing/show/1347755
http://www.medhelp.org/posts/HIV-Prevention/Need-your-help/show/1345664
3) Online testing services have their place, and in fact I recommend them strongly in some circumstances. (I'm well aware they serve only as agents for indepedent labs, like LabCorp or Quest.) Such testing is often a good option for someone who has been sexually active in general, but has no symptoms. However, if someone has a specific exposure they are concerned about, or if they have symptoms, it's often best to see a health professional in person. Professional advice by an expert can put all the information into context -- the nature of the exposure, the symptoms, etc -- and can better advice a) which tests to have and b) how to interpret the test results in light of all the available information. In addition, many online testing services take advantage of patients' anxieties by encouraging (or not discouraging) many tests that may not be necessary, often at great expense.
In your case, it seems you have an objective slant, and you're dealing with HIV testing only, not an extensive "STI panel" of multiple tests. I have no problem with it.
Regards-- HHH, MD
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