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HIV testing confusion
I would like to post my question in a non-confrontational manner - why do HIV specialists use RNA tests when the various on-line forums constantly say that those tests aren't conclusive? Does having a 21 day and 61 day RNA test both coming back undetectable (<20) conclusively prove that I'm negative? Why didn't my specialist even mention having an antibody test?
Best Answer
I have to agree with you on this subject,if the doctors in the expert forum know that there are no tests marketed or sold to give a negative test result earlier than 3 months post-exposure then how is it possible then that they can say to a poster that their test results are conclusive at 4 weeks,6 weeks,8 weeks,etc.when they are fully aware of the guidelines,can someone please explain this situation once and for all.
Hi everyone -
Our experts do say often that testing is conclusive earlier than the guidelines, so while it is confusing, it's a good thing to get all the info possible while making your personal testing decisions.
This thread is now closed.
Thanks,
Emily
********************************* CLOSED THREAD ***************************
NO MORE POSTS, PLEASE
Our experts do say often that testing is conclusive earlier than the guidelines, so while it is confusing, it's a good thing to get all the info possible while making your personal testing decisions.
This thread is now closed.
Thanks,
Emily
********************************* CLOSED THREAD ***************************
NO MORE POSTS, PLEASE
OK, that's fair enough and a guideline is a guideline, but what's wrong with Having a DUO test say at 3 to 4 weeks post-exposure and then follow up with a final antibody test at 12 weeks to adhere to the guidelines.That makes sense doesn't it?
Freedom of speech anyone can say anything but that does make it correct and you cannot find one approval that states that a test was approved to give a conclusive negative result earlier than 3 months post exposure.
UK Fourth Generation Testing
http://www.bhiva.org/documents/Guidelines/Testing/GlinesHIVTest08.pdf
Post testing
Page 11
The need for a repeat HIV test if still within the window period after a specific exposure should be discussed. Although fourth generation tests shorten the time from exposure to seroconversion a repeat test at three months is still recommended to definitively exclude HIV infection.
Dr. Jose Gonzalez-Garcia, MD, MBBS, LMS, MRCP(UK), MRCGP, PhD
Dec 06, 2011 To: jjllmm
Hello,
Thank you very much for your post and welcome to our forum. I am afraid that it is going to be me answering your question, and not my colleague, Dr Sean.
It is certainly quite unfortunate that you had contracted herpes type 2 in this unprotected sexual encounter. The negative test that you had at 8 weeks is certainly highly reassuring and a very good indication as it is possible to detect the HIV antibodies already at that stage. However current UK guidelines still recommend to have a final test at 12 weeks for it to be considered final and fully conclusive. Having said all that, and speaking out of my own clinical experience, I have never come across anyone testing negative at 8 weeks and then positive at 12 weeks. Therefore I am very confident that you are HIV negative.
Best wishes,
Dr José
UK Fourth Generation Testing
http://www.bhiva.org/documents/Guidelines/Testing/GlinesHIVTest08.pdf
Post testing
Page 11
The need for a repeat HIV test if still within the window period after a specific exposure should be discussed. Although fourth generation tests shorten the time from exposure to seroconversion a repeat test at three months is still recommended to definitively exclude HIV infection.
Dr. Jose Gonzalez-Garcia, MD, MBBS, LMS, MRCP(UK), MRCGP, PhD
Dec 06, 2011 To: jjllmm
Hello,
Thank you very much for your post and welcome to our forum. I am afraid that it is going to be me answering your question, and not my colleague, Dr Sean.
It is certainly quite unfortunate that you had contracted herpes type 2 in this unprotected sexual encounter. The negative test that you had at 8 weeks is certainly highly reassuring and a very good indication as it is possible to detect the HIV antibodies already at that stage. However current UK guidelines still recommend to have a final test at 12 weeks for it to be considered final and fully conclusive. Having said all that, and speaking out of my own clinical experience, I have never come across anyone testing negative at 8 weeks and then positive at 12 weeks. Therefore I am very confident that you are HIV negative.
Best wishes,
Dr José
"I don't think I my account should be warned for asking a reasonable question." Take that up with a moderator then.
And this is why I asked the question: CAN YOU SEE HOW THIS DISPARITY BETWEEN WHAT DOCTORS SAY AND WHAT TESTS ARE APPROVED CAN DRIVE A PATIENT CRAZY? I don't think I my account should be warned for asking a reasonable question.
PCR-RNA test are NOT APPROVED to give a conclusive negative test result by itself. There are no tests marketed or sold to give a conclusive negative test result earlier than three months post exposure.
PCR-RNA tests are not standalone tests are cannot give a conclusive negative test result by itself.
Well then that's the problem - doctors making decisions based on unapproved testing. Can you see how this disparity could drive the patient crazy?
Only 2 weeks ago from Dr garcia,"Yes you had a very high risk exposure with a known HIV+ person,however I consider your two negative DUO tests both at 4 weeks and 7 weeks post-exposure fully conclusive and no further testing is required"This assessment was made after the highest risk possible for HIV transmission.
UK Fourth Generation Testing
http://www.bhiva.org/documents/Guidelines/Testing/GlinesHIVTest08.pdf
Post testing
Page 11
The need for a repeat HIV test if still within the window period after a specific exposure should be discussed. Although fourth generation tests shorten the time from exposure to seroconversion a repeat test at three months is still recommended to definitively exclude HIV infection.
Dec 06, 2011 To: jjllmm
Hello,
Thank you very much for your post and welcome to our forum. I am afraid that it is going to be me answering your question, and not my colleague, Dr Sean.
It is certainly quite unfortunate that you had contracted herpes type 2 in this unprotected sexual encounter. The negative test that you had at 8 weeks is certainly highly reassuring and a very good indication as it is possible to detect the HIV antibodies already at that stage. However current UK guidelines still recommend to have a final test at 12 weeks for it to be considered final and fully conclusive. Having said all that, and speaking out of my own clinical experience, I have never come across anyone testing negative at 8 weeks and then positive at 12 weeks. Therefore I am very confident that you are HIV negative.
Best wishes,
Dr José
That`s right they are real Specialists! I have spocen to a lot`s of Specialist and it is depending on of they follow the Guid lines or there Expereance.
The Lab i did my Test are saying that a 4th Generation Test is conclusive at day 21 (i don`t believe). Some af them are sying it is conclusive at 6 Weeks and some are saying at 12 weeks.
Sins Years in Germany you get your HIV Test for free if you go to the (it calls Gesundheitsamt). The reason is to find out when a Test will be conclusive and i am sure they will change the Guid lines wery soon.
The Lab i did my Test are saying that a 4th Generation Test is conclusive at day 21 (i don`t believe). Some af them are sying it is conclusive at 6 Weeks and some are saying at 12 weeks.
Sins Years in Germany you get your HIV Test for free if you go to the (it calls Gesundheitsamt). The reason is to find out when a Test will be conclusive and i am sure they will change the Guid lines wery soon.
Dr Sean cummings and Dr Jose Garcia know more about HIV and HIV window periods for certain HIV tests and that's a fact.Their assessments are both accurate and reliable and should be believed.No one on this community forum has the right to challenge them in any way.
You have to see it a bit differnt. The CDC 3 month is also for lets say Afrika where they are using just 1st 2nd and 3th Generation rapit Tests! Some Specialist in Europe are already saying that PCR is conclusive like a Antiboday Test at12 Weeks but that is still not the guid line.
Teak is right because of the CDC and you can not do better after your PCR u did already and a Antibody Test at 12/13 Weeks.
Then you follow the CDC....
Teak is right because of the CDC and you can not do better after your PCR u did already and a Antibody Test at 12/13 Weeks.
Then you follow the CDC....
Teak, begging your pardon, but why did you reply "tend to agree"? If it's as black & white as you've always stated, why don't you totally agree with me? Under what conditions would you not agree?
Furthermore, what's the point of all of this pre-3 month testing run by ID specialists? Do you think that ID specialists run these tests to just run up the bill for the worried well? Why don't they just tell the worried well to sit home for 90 days instead? Perhaps there's no money to be made in that?
Furthermore, what's the point of all of this pre-3 month testing run by ID specialists? Do you think that ID specialists run these tests to just run up the bill for the worried well? Why don't they just tell the worried well to sit home for 90 days instead? Perhaps there's no money to be made in that?
You're exactly right - then the specialists should tell their patients what you just wrote, instead of running thousands of dollars of unapproved testing, and then based on the results of those unapproved tests, tell their patients that they are conclusively negative.
PCR-RNA tests are not appoved diagnostic tests and feel free to show the test approval that says any different.
Teak, I have no reason to lie to you - my HIV Specialist is board certified, I don't know how else one deems the how "true" a specialist is; I will gladly provide you with her name in a private message. She actually referred me to a psychologist after my second negative RNA test because she believes that my symptoms are in my head. Also, I telephoned Capitol Hill Medical Center in Seattle, and they said that a three week RNA test is conclusive. This is not to say that these HIV specialists are right and the CDC 3 month antibody requirement is wrong - I will be going for the 3 month antibody test next month ON MY OWN ACCORD, even though my future shrink and my current HIV specialist and a clinic in Seattle that caters to gay men all say that my previous RNA tests are conclusive. All I'm trying to point out is that anyone in my situation would like a level of consistency (as opposed to a contradiction, which only adds to the overall anxiety) between the medical community and on-line community. Apparently this contradiction will go on forever: while you are canonically correct for stating CDC guidelines (at no cost to the worried well), the specialists will continue to collect large fees for multiple medical appointments and expensive RNA tests that they feel justify their prognosis.So the bottom line is that your advice is by the book and free (and I genuinely thank you and commend you for responding to me and thousands of others), while their advice is avant garde and expensive. Like you, I would not want anyone in this situation to be given a false negative result, and I hope and pray that the ID specialists never put someone in that hell (including me).
Does that mean Dr Garcia and Dr Handsfield are not HIV specialist only Medical doctors???
Teak, that's what I expected you to say - you've said it many times, and I'm not disagreeing with you. I just wish that some common ground existed between the on-line community (such as yourself) and the medical community (such as my HIV specialist). Why is there such disparity?
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