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HIV accuracy testing
Apr 7, 2003

I am worried about the possibility of HIV infection. I have a number of symptoms which might be interpreted as HIV infection. My question relates though to the accuracy of tests I have had done. I have tested negative on both home and GUM clinic tests. I read recently on one web site, however, that HIV antibodies can disappear completely from blood during HIV's latent stage. If so, surely no test could reasonably claim to be +99 accurate. Are they only accurate for recently acquired HIV? Please, please help in clarifying this situation. Many thanks.

Response from Mr. Kull

HIV antibodies do not disappear. So, the HIV antibody tests have an extremely high accuracy (99.9% if conducted 3-6 months after exposure).

Once a person develops antibodies to HIV (seroconvert) they do not serorevert--that is, go back to be HIV antibody negative. So, an infected person should always test HIV antibody positive after the window period.

People may serorevert after being vaccinated against certain infections. This is why some vaccinations require a series of shots (like Hepatitis B, to make sure that the antibodies hold) or booster shots throughout one's life (for instance, measles, mumps, and rubella).

The only times that HIV seroreversion might happen is in an infant of an infected mother, when someone is in the late stage of infection (AIDS), or after prolonged treatment with antiviral medications. An uninfected infant may retain the antibodies of the mother in its bloodstream for up to 18 months yet remain uninfected. In the other two cases, which have been minimally documented, there is an assumption that HIV infection would be clear through the presence of opportunistic infections (someone with AIDS would have to be extremely sick to serorevert) or previous diagnosis of infection through antibody or other testing means.

Try not to question the accuracy of your antibody tests.

RMK



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