hiv-testing after 6 weeks ???

[smurfy]

Dear Dr. HHH,

i am from Vienna, Austria (europe). I hope my english is good enough ;-)

I have read all your posts about the "windows period" with hiv-testing. YOUR opinion is that
after 6 weeks a negative hiv-test is close to 100% confident.

But ALL (very serious) sources here in europe (austria, germany) in the internet, and ALSO DOCTORS say the following:

after 4 weeks: 60-65 %
after 6 weeks: 80 %
after 8 weeks: 90 %
after 10 weeks : 95 %
after 12 weeks: nearly 100%

I think we use the SAME tests here in 'modern' europe as in america. (3 rd generation and 4 th generation)

So from where YOU have your numbers and why you are so sure about "6 weeks is nearly 100%"  ???

I had a risk 6 weeks ago (unprotected sex). The 4th generation test (combined antibody/antigen test)
was negative after 6 weeks. for YOU this is nearly 100% confident, for most of the people here in
europe only 80 %.

regards from austria

[H. Hunter Handsfield, M.D.]

Thanks for your comments.  Your english is fine!

My advice is based on data generally cited in the United States, from various sources.  Yours are much more conservative than most experts believe.  As I have stated before, part of the problem is in knowing when to "start the clock".  The large majority of data on seroconversion time are based on studies in persons at high risk for HIV--which is logical, since they account for the vast majority of new infections.  The problem is that there few such persons who know exactly when they were exposed.  This generates considerable uncertainty in calculating seroconversion time.  Such data were more readily available early in the AIDS era, when transfusion-related cases often provided a precise date of exposure, but such cases now are rare (with the modern HIV tests).

Few physicians providing care to HIV infected people can recall ever seeing a patient who was HIV negative at 6 weeks, who later was proved to be infected.  This alone suggests the 80% figure is too low.

In the end, none of this matters too much, especially when advising people at almost zero (or truly zero) risk of acquiring HIV, which is the case with most questioners on this forum.  The bottom line is that someone truly at risk indeed needs testing out through 3 months--for them it doesn't matter whether or not they  have negative tests at 4, 6, or 8 weeks.  For those at almost no risk, a 4-6 week negative result is (or should be) highly reassuring.  The rest is quibbling.

Thanks again for allowing me to clarify this (again!).  Merry Christmas--

HHH, MD

[joeworried]

The reason all the doctors are giving you the same information is because they're all reading from the same script.  

There are many studies you can read on the Internet if you go to a standard search engine like google.  Everything I've read supports a much higher percentage than 80% at 6 weeks.  To complete the picture on the information provided by carnageofthepast, a first generation test will detect HIV antibodies about a week later than a third generation test, and a second generation test will detect the antibodies a few days earlier than a first generation test.

The state of New York provides HIV/AIDS information in a form of 100 questions and answers.  In the response to question 39, it states "With the HIV antibody tests used in New York State, virtually all people who are infected will test positive within one month of being infected.  Most people will test positive even sooner."

You can draw your own conclusions, but if "virtually all" test positive at 1 month, the percentage testing positive at 6 weeks has to be much greater than 80%.  As an FYI, I tested negative at 8.5 weeks after a possible exposure using a second generation test (by LabCorp).

[morestup]

Hi Strangeworld

Merry Christmas to you too.  Hope you have had a good day.

My symptoms in my stomach have receded somewhat but not completely.  However last two days I feel my lymph nodes a little more and I feel more tired.

But I guess that at 9 weeks being negative is 95% approx accurate.  I cannot wait to get to 13 weeks and put this all behind me.  And I guess you too as well.  So that we can just get on with our lives once and for all and learn from this torturing experience.  I have never felt worse in my entire life.  

I still check for rashes and other symptoms, but I'm on the forum to check recent questions and thanks to Smurfy I am waiting for Doc HHH's reply.  

God Bless

[Candelario10]

I had sex with an older woman on oct 20 2009 and the last time I had sex with her was December 1 2009 I am a hypercondriac so I though I had HIV. Got tested on December 29 my test came back negative but I still think I should get tested again in a couple days. What's your thoughts?

[H. Hunter Handsfield, M.D.]

First, there is almost no such thing as high risk vaginal intercourse, unless one partner is known to be HIV infected.  Perhaps more important, for sexual exposure to HIV, it makes little sense to describe any particular exposure as high or low risk.  The risk comes from patterns of behavior.  For example, a pattern of repeated unprotected anal sex among popuulations with high prevalence of HIV (e.g., gay men) is very high risk, even though the risk for any particular exposure actually is very low.  Vaginal sex in industrialized countries, even without condoms:  pretty low risk.  With condoms regularly?  Extremely low risk.  Unprotected orral sex? Trivial risk.  And so on.

HHH, MD

[Allison07]

There is research available (that I have found myself) that substantiates a shorter window time for modern tests. Even an antibody test at 4 weeks should be pretty highly reliable. The only circumstances I think may delay a 6 week window time would be for those who:

1) Have a pre-existing immune system disorder
2) An induced immune deficit from for example, going through
   chemotherapy
3) Or if the person had been undergoing heavy antiviral  
   treatment

But Dr. H may say differently about this.

[crazysumit]

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[Comeup]

I have an oral sex with someone who I am not sure whether is infected. I have carry out the test 2 weeks later and it turn to be negative. I have no sign bit still worried. what is the best advice

[Ben1511]

Hi I had an oral encounter with a prostitute and didn't use a condom, I had a HIV test at 8 weeks and it was negative, however I'm Gavin pains in my chest and armpit as well as other flu like symptoms, should I be worried?

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[smurfy]

Hello Doctor HHH,

thanks again for your professional answer.

For me, there is one question left: can i sleep well with
my 6-week 4th generation test (antibody/antigen) being
negative in my case (condom broken as described in my last post) ? I am still a little bit worried, maybe you
understand this, because one more doctor told a fried
of mine 2 days ago that 6 weeks are ONLY 80% reliable.
Why is this 80%-number in the minds of european doctors ???

[smurfy]

Hello Dr. HHH,

many thanks for your very very interesting answer !

there is one question left for me: what do you think is
an 'high risk' and what is a 'low risk' ??

My case is the following: i had sex with a girl who is
....i would say 'very openend' for having sex with many
men... The condome we used broke at the end. I was
in her vagina for about 30-60 seconds and i had my
ejaculation (is this the right english word ???)
in her vagina.

She has an negativ hiv-test from october. But i am worried
she got infected the last 4 month before our 'condom break' (in November).
She promissed me that she never had unprotected sex, only
with her ex-husband (about 2 month ago).  And i know she
is drinking a lot sometimes.........so i am worried she has herself NOT under control.

what do you think ? is this HIGH or LOW risk in your opinion ? what does my negative 4th generation antibody/antigen test after 6 weeks mean to ME ??

[carnageofthepast]

an antigen/antibody test at 6 weeks is almost 100percent reliable.  there was a study done in 1997 comparing different hiv tests and how fast they picked up positive results.  p24 tests almost always show up within 2-3weeks of being infected and the antibody shows around 7 days after the p24 shows.  You are reliably negative but if you must reassure yourself, get a test at 12 weeks so you can let the stress go.

[strangeworld]

morestup--- Do you still have those symptoms ??? My stomach makes lot of noises and some days i get some slight calf pain???

I am going to test in 3 weeks with  you.
Confused and scared...i have insertive oral with a high risk female for not more than 20 seconds...


Happy Holidays :-)

[morestup]

check my thread:

http://www.medhelp.org/forums/STD/messages/2169.html

I agree you with you that there still needs to be a general consensus from all official health organisations as to clarify this 6 week, 3 month and 6 month.

But the main investigation done by CDC USA is that most people will have positive antibodies within 4 weeks.  Thus the 6 week mark is 95% accurate according to Doc HHH.

As I have not received a clear answer from Doc HHH and other sources all say 3 months, I will test again in 3 weeks which will make it the 3 month for me.

Lets hope the Doc is right in saying 6 weeks is almost 100% and not get a scare when we do the 3 month test.

In the meantime, take your 6 week negative as conclusive.

Best Wishes

[smurfy]

Hello to all of you,

is there a link to the source of the research ? can i
see it somewhere in the internet ?

well, there must be a reason why all the sources here
in europe are talking about the numbers i have posted before.

Doc. HHH was the FIRST one who says that a six week test should be okay nearly 100% !

[morestup]

Hey Smurfy

You wanted evidence?

Below is the source from which Will posted:

Willl
12/16/2005
C3  . Also like has been said before on this forum the tests are better now. I found this document from the CDC given the average window of 25 days (CI 9-41 days), and this was printed back in 1996.

http://www.cdc.gov/mmwr/PDF/RR/RR4502.pdf

[morestup]

Smurfy

I have to agree with you.

Doc HHH has to clarify the question of the 6 week mark once and for all.

All the other sources indicate 3 and/or 6 months.

My Doc said 8 weeks is a reliable indicator.

And according to your data, my 9 week negative result is more than 90% accurate.

I think it may be the fact that it depends on whether your case is low risk or high risk.  I have seen on other threads that if it is low risk then 6 weeks is sufficient.  What is low risk - oral sex.  High risk - unprotected vaginal or anal sex.  

But for some oral sex cases raised on this forum where the other partner was infected, the Doc said to have a further test at 3 months.  but with me he said 6 weeks was conclusive, despite knowing i had unprotected insertive oral sex with a two high risk females.

To be honest......i am also confused.

Doc, Merry Christmas to you.

Would appreciate a clarification on this Please.