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A long road of uncertainty
Jul 31, 2004

Hello Bob , Hiv Expert, so let me get this straight...3 months can be definative...it also may not be definative....6 months is conclusive but it may not be conclusive...some people can take 2 weeks to be detected but a few can go 12 months undetected. So 20 odd years of research has only brought us this closer to understanding the disease.Great. It just shows where we stand.

My question is , If we are so unsure when a person seroconverts , why not play it safe by extending the window period to a safety net of 12 months...probably some experts/doctors have big egos and huge pride about the research ythey've done and come up with fantastic opinions of their own defination on the window period....but if you want to truly see this disease elimintated, isn't it safe to advise people to " Hold it off" until about 12 months instead of 12 weeks ?

I had a 5 month negative test on generation 4 elisa , the doctor advised me to come back in another 6 months just to be sure to some strange symptoms. It's very disappointing when you get such news. You take so long to be in the clear. But ANYWAY I'm gonna just listen to him. Why? I'm not a person who can hurt someone else by listening to Hiv experts with huge egos whom can't really make up their mind on the window period.

Before they find a cure, I hope they can find better tests.

PS ; Do i think you would post this messages, i will put my bet that you won't. Reason: You can't post questions you can't answer.

Response from Dr. Frascino

Hello,

First of all, it's really not a question of us experts not being able to make up our minds. After all, we are not trying to decide on paisley versus striped wallpaper here! So your comments are out of line. Science is science. Twenty years into the epidemic, we have learned a great deal about the virus: how to detect it, how to measure it, and how to control its replication with antiretroviral drugs. We also have learned how to prevent getting it in the first place. (Apparently that's a lesson you haven't quite mastered yet.)

Next, why the crack about big egos? I hope you weren't referring to me or to my many colleagues who have devoted their lives to battling the pandemic. I'm sorry you've placed yourself at some kind of risk for HIV and that now science cannot give you the degree of immediate reassurance you desire that you have indeed dodged the bullet. Please remember you are talking to someone who wasn't so lucky.

Regarding your situation, I have no information about your potential exposure or "strange symptoms." In many cases, I would indeed advise that a five-month negative ELISA was conclusive. Should you take another six-month test? That's entirely up to you. I, too, would suggest you follow your doctor's advice, as he/she has all the details of your exposure, has evaluated your symptoms, and has performed a physical exam. I certainly would not argue with a suggestion by a competent HIV-knowledgeable physician to retest if indeed their was reason to doubt the 3 month result. In all likelihood, however, your follow-up test will probably be negative. I certainly hope it is.

Why do experts have different opinions? Please read the archives, as I've explained this many times before. Let me give you an example. Do you ever walk outside when it's raining? You do? OK. Do you realize there is a very slight risk that you might get zapped dead as a doornail by an errant lightning bolt? It really could happen, but since the chance of it happening is so slight, you probably never give it a second thought. But to be really, really, really safe, you probably shouldn't leave the house when it rains. So what answer do you get if you ask an expert, "Will I get hit by lightening if I walk from my house in the rain?" I would say, "No." However, if you persist and say that you need to be absolutely, positively, 100% sure that you're not going to get fried by a lightening bolt, well then the advice from an expert would have to be: don't go out in a rainstorm.

Last, you lost your bet. Your question is posted. Why wouldn't I post a question I don't know the answer to? I certainly don't claim to know everything. When I don't know, I say that I don't know.

I do hope your follow-up tests remain negative. But I also hope your negative attitude becomes a bit more positive before you post another rant or question here.

Good luck.

Dr. Bob



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