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Avatar universal

window period

Hello,i would like to ask about the window period..it is so confusing.6 weeks,3 months,6 months?what about the new generation tests..when can we be absolutely confident with our results?
52 Responses
Avatar universal
massachussets calls a 6 week all clear.  With newer tests ie 3rd and 4th generation you can feel rather assured in a 6-8 week neg test.  The 3 month thing is a CYA statement created by test manufacturers.
Avatar universal
Thanks,when you say 6-8 weeks,you mean it is the same at 6 and at 8 weeks?i tested at 6 1/2 weeks with the ag/ab test(i think it is 4th generation).Do you think is enough?the biochemical at the hospital told me that i am o.k,but i keep reading all these about the 3 and 6 month period..
Avatar universal
your fine.. Its like a bell curve.  Once you reach 4 weeks your talking about deviding a percent.  THe people that take longer are people with immune disorders which you would be aware of.  I have searched the net more than anyone reguarding HIV and I have yet to see someone say they've seen 6 weeks turn pos later.  All I hear is MD's saying theyve never seen it.  That should tell you something
Avatar universal
dont wast your time looking for stuff on the net.  I've already sone it for you...

http://www.medhelp.org/forums/STD/messages/524.html

http://www.medhelp.org/forums/HIV/messages/258.html

http://huhs.harvard.edu/HealthInformation/HIVTesting.htm

http://www.aegis.com/askdoc/ASKD040318.html

http://www.aegis.com/askdoc/ASKD040617.html

http://www.sfaf.org/aboutsfaf/outreach/index.html?april00/two_tests.html~frontpage

http://peds.wustl.edu/labmed/retrovirus/

http://experts.about.com/q/Immunology-including-AIDS-973/ELiSA-6-Weeks.htm

http://www.thebody.com/Forums/AIDS/Women/Archive/WomenInfected/Q159734.html

http://www.areuatrisk.com/Learn/aids_hiv.php

http://liam.gnn.tv/print/1775/HIV_Antibody_Assays_Overview

http://www.retroconference.org/2001/posters/415.pdf  (Figure1)

http://www.health24.com/medical/Condition_centres/777-792-814-1753,33966.asp

http://www.aac.org/site/PageServer?pagename=basics_home

http://forums.poz.com/index.php?topic=2523.0

http://www.aegis.com/askdoc/ASKD040318.html

http://www.hopkins-aids.edu/publications/book/03MMHIV1to3.pdf  (page 7)

http://www.unaids.org/en/MediaCentre/References/default.asp#begin (q:32)

http://www.thebody.com/Forums/AIDS/SideEffects/Archive/Testing/Q142661.html

http://depts.washington.edu/hivaids/initial/case1/discussion.html (figure 7)

http://experts.about.com/q/Immunology-including-AIDS-973/u.htm
Avatar universal
Hey,you are great!
Do you know if the ag/ab test is always a 4th generation test..the guy at the hospital didnt know about the generation of the tests..just told me it is very accurate since it is a combination with the antigen.
thanks again
Avatar universal
its a 3rd or 4th which are the same when it comes to checking antibodies.
Avatar universal
With a 6 week test post possible HIV transmission scare through sexual contect, Doc H. will generally put you in "ALMOST" all clear. Congrats!!!

Skerd: Any comment on this:
http://www.healingwell.com/community/default.aspx?f=6&m=518837
Note: Maybe the difference was non-sexual transmission.
Avatar universal
You believe everything you read?
Avatar universal
Trust me...really dont wana...U bet i wana live :)
Avatar universal
I've read that before and it sounds shady to me.  I dont believe you get HIV from fighting.  It would be way rare.  I do believe you get it from being with another man or woman which would be a more likely senerio.  What else could you tell your GF/Wife?  It just sounds like a wierd post.
Avatar universal

The window period was the most confusing part of my own long journey into HIV madness. Every damned website had something different to say about it, as well as my risks for having caught HIV in the first place (unprotected oral sex, me on her).

Let's see, I started off by going to a doctor and asking him. He said, and I quote: any little cut in my mouth could have given me HIV. If I was in panic mode before, I was in full on desperate, crazy as bat sh*t panic mode after that. Stupid doctor - I don't go to him anymore. He also said I'd have to wait 6 months to get a conclusive test. Now I was really freaked.

Luckily, I just didn't believe him. So, called CDC, who told me my risk for having caught HIV was significant, and that I'd have to wait 6 months. At this point, I was really going nuts. So, kept looking, and eventually found my way here. Doc told me 6 weeks, told me my risk was pretty insignificant and and answered my questions and, after 6 weeks, I began to feel better. I still went and got tested at 9 weeks and again today, the 6 month mark, but I was much less of a basket case than I had been. All my tests negative, and I realize now I could have stopped and been happy at the 6 or 9 week mark.

So, I am glad that I found this place. Still pop in to read some of the posts. Glad they have started up the HIV Support forum. Seemed to me that most of the posters here needed mental and emotional support more than anything else.
Avatar universal
I just got my 6 month negative result, today!  I had a known positive high risk exposure, unbeknownst to me at the time.  Had a 6.5 week elisa and a 60 day PCR DNA, both negative.  These results gave me the courage to grind it out another 4 months...

My Doc told me the PCR DNA is solid.
Avatar universal

Congrats on your negative test result! I also had a doc that told me that the DNA PCR was fine for testing purposes. Then again, doc here wouldn't recommend it. And, talked to at least one person from here who did it and was sorry that he did.

Maybe it's just a matter of personal preference. I probably wouldn't do it again if I had it to do all over again.
Avatar universal
Same to you my friend.  This has been 6 months from hell. Time to move forward with my life.  I think Dr. HHH is excellent, by the way.  Compared with the people on The Body.com, he was really the only one out there that attested to a 6 week neg. elisa as being reliable.  Not true with any other website out there.  This also helped carry me thru these many days.  Good luck with you.
Avatar universal
I second the DNA PCR test.  This test is more sensitive than what they test the blood supply with.
From all my research and what I've heard from doctors, this test-when performed at experienced laboratories is 100% sensitive at 2.5 months.  One more time... 100%. Not sure about one month, although they claim >99%, But with the research I've found, after at least 60-70 days it's 100%. There is the real possibility of a false positive, however, probably the MAIN reason this test is not FDA approved.  Another reason, is that this test is considered definitive at one month, about the same time at least 90% turn positive on antibody tests- no real value.   The only reason someone should take this test is if they have a known high risk exposure and suffer symptoms of ARS, and even in that circumstance the RNA PCR would be of more value.  Another reason, if someone has some serious mental health problems and think they are a late seroconverter.  But even then, they would still think that the test was not accurate.  Finally, if you have some serious, serious health issues, negative antibody testsm and the doctor's suspect possible HIV infection.
Avatar universal
I did fit in that category of high risk, and at the time did not know about the chance of a false positive.  That 60 day negative result gave me the stamina to stick it out some more just in case. After 6 months, and 5 days, I CAN FINALLY BREATHE RELIEF!!!
Avatar universal
ELISA

6 week test = very reliable
8 week + =  accurate
10 week + same as above
12 week = same as above
6 month = same as above
Avatar universal
hey,
My understanding suggests that DNA PCR is sensitive when it is optimized for paticular set of strains to which the person has been exposed to. If the person is exposed to a strain not covered by the DNA PCR test, it will not be detected. Proviral DNA PCR tests look out for HIV-1 only and also are not considered good for detecting non-B subtypes.
Avatar universal
First, if you are worried about HIV-2, then you are beyond rational.  I am supremely confident that well less than one percent of individuals infected in the US are HIV-2.  If you desire an HIV-2 DNA PCR test, then get one.  
Second, when you say different strains, I assume you are discussing subtypes.  Today's DNA PCR's include primers for ALL subtypes.  If one is conducting a DNA PCR test on an individual suspected to be infected with HIV, then how could they know what particular strain to test for?  That og, is why experienced laboratories use primers for all subtypes.  
Third, if you are now concerned about recombinant strains and HIV hiding in nervous tissue, you are well beyond any reasonable or rational thinking and you might want to seek help from a mental health professional.  Just saying.

Finally, you can find much research on the extreme sensitivity of this test all over the web.  Also, false negatives on DNA PCR's are so rare today, that if it happens, it gets written up in medical journals.
Avatar universal
For a little assurance, check out the write up on the performance of the DNA PCR at two months detecting subtype A and E.  You can find it on medscape.  [100%]
Avatar universal
My exposure was in Italy so that's why I am worried on the strain aspect and with the ongoing symptoms. By DNA PCR, are you referring to the Proviral DNA PCR or bDNA? Anyways, thanks for the enlightenment.

Also, I read Daisey's case at the body bulletin boards and the information she wrote about DNA PCR's so that had an influence on my outlook towards the test.
Avatar universal
Crazy cobal brought Daisy up to me awhile ago.  Here's the thing with that "case."

1.)  If in fact she had a negative DNA PCR, for what reason one was ordered, I do not know, because the bDNA or RNA PCR is the recommended quantitative assay today for primary infection, but it either a)was taken before one month, or b)was a false negative.  Now, there a few reasons for the latter, a. she is not infected-which seems pretty likely considering her posted CD4 count and ratio which she posted after being confronted on that forum.
b. her husband from the army, who I am sure has been deploying to far off lands, acquired HIV from another country resulting in a uncommon strain.  Keep in mind, the DNA PCR when conducted in clinical practice achieves only 96% accuracy.  (For 100% sensitivity you must be sure that the lab you are using is experienced and uses ALL primers.)

2. Now when I further considered that case, there are a number of holes which I would like to share.  First, she claimed to experience a mono like illness(ARS) 2.5 months after her last exposure. Possible but unheard of and very unlikely.  Next, she states she has had a number of false negative oraquicks even well after the window period.  The only way that's possible is if the clinic she goes to got a BAD batch of tests.  Third, she continues to have negative RNA PCR's including one during ARS.  Finally her labs which she posted on that forum illustrated a very normal and healthy immune system consisting of >800 CD4's and descent CD4 ratio.

Put those altogether and you have a case for an interview on 60 minutes, right along with KenpoJohn.

You can read these accounts from numerous individuals all across cyberspace and take away what you will, I on the other hand would much rather listen to organizations such as Hopkins, Harvard, WHO, CDC, New York State Health Department, GMHC and so on.
Avatar universal
I agree with you about other things regarding Daisey & ken's stories. But, as far as what you have written about Quantitative RNA PCR as recommeneded test to detect primary infection, I kind of disagree but correct me if I am wrong. In order to establish that infection exists in the 1st place, a DNA PCR is recommended before formation of antibodies. DNA PCR can still be considered a diagnostic test which is often used in finding the virus in infants but RNA PCR is meant to check the viral load for disease progression. RNA PCR is more prone to give false positives as well.
Avatar universal
Okay grasshopper, listen up.

The quantitative RNA PCR is the most desirable viral assay used to diagnose primary infection.  Research proves that once an individual is infected, the virus multiplies rapidly and immediately-sometimes reaching in the millions per mL during Primary infection(2-4 weeks), before the development of antibodies.  So, the RNA PCR would read a very high viral load in the first few weeks of infection prompting the doctor and patient to consider treatment in an effort to halt serious damage to the immune system.  The statistic of false positives can be as high as ten percent, but the doctor can usually recognize these because they mostly display low titers, i.e. < 10000 per mL.

The time delay until a DNA PCR is 96% sensitive is no earlier than one month-at least from what I know.  If you want 100% sensitivity, research shows 2 months.  So what good is a DNA PCR during primary infection? That's right, it isn't.  Remember, antibody tests are virtually all positive within the first month (90-95%) at least the elisa, and greater than 99 percent at two months.

So you see, that is why a DNA PCR is not used very often, unless in the diagnosis of a newborn, where antibody tests are useless for at least a year--or in a case where an individual has multiple indeterminate WB results.  These tests are very difficult to perform, require highly skilled $$technicians$$, and a lot of $$time$$.  Hence the reason they are not recommended for diagnostic purposes in the everyday adult HIV screening.  [Become positive same time as antibody test, higher rate of false positives, raise healthcare costs].

Finally, the RNA PCR might not be used to monitor disease progression anymore.  Recent published research demonstrates that one's viral load does not have much of an affect on the  progression to AIDS as once thought.
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