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some info
Oct 3, 2001

hi,

i've some info (which might interest some worried wells).....

"The first step in HIV testing in adults is a screening antibody detection test using the enzyme-linked immunosorbent assay (EIA). The newer, third-generation EIA kits have sensitivities of 99.4100 and specificities of 99100.2833

For blood samples that test positive the EIA test is repeated twice. If both repeat tests give negative results, the sample is reported as negative. False-negative results are possible if blood is taken during the seroconversion window. It has been determined that seroconversion will occur within 3 months in more than 97 of infected individuals and in most cases within 28 weeks.34 Testing and mathematical models using the third-generation EIA tests have found the seroconversion window to be on average 20.3 (95 confidence interval [CI] 832.5) to 25 (95 CI 941) days.35,36 The US Centers for Disease Control and Prevention, however, reported a case in which a patient had culture-positive results indicating HIV infection but repeatedly negative EIA results over a 4-year period.37 Health Canada recommends that people seeking HIV testing who have self-reported high-risk behaviours and whose initial EIA result is negative should have repeat serological testing performed after 6 months.34 "

as taken from: http://www.cma.ca/cmaj/vol-158/issue-11/1449.htm

i do, however, have a couple of questions.....

1. cases over 1 year (eg the 4 year case) was when 1st and 2nd tests were used (i think). are 3rd generation tests almost exclusively used nowadays? if so my negative result at 7 weeks is good news - would you agree?

2. my only risk factor was just RECEIVING oral sex from a woman (i'm a man), and the cdc have told me basically no risk unless there was a lot of blood in her mouth (which, i'm sure you'll agree, is very unlikely). furthermore, there's been no documented cases. however, studies on this look inconclusive. i also had some convincing symptons. if i was +ve would my doctor be obliged, or encouraged, to report my case? otherwise, how do people like the cdc know what's risky and what's not?

Thanks for your time.

ps. sorry for the long message!

Response from Dr. Young

Thank you for your thoughtful question and information.

Different agencies may use different antibody tests to detect HIV; most use the third generation test.

A negative test at 7 weeks is very good news, though based on what you have quoted, a 12 and 24 week test would cement the negative status.

Based on the kind of exposure that you describe, I would emagine that your risk is very, very low. Most of the cases of transmission from oral sex are from anectodal reports of gay men.

As for reporting, different states have different reporting and follow up procedures. Here in Colorado, follow up is voluntary, but physicians are encouraged to assist the state health department in contacting patients in order to assess risk behavior and the epidemiology of new infections.

Thanks again. BY



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