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Never-before-answered-question about the Window Period
Nov 14, 2005

Hello Bob: You really are great at responding to people's concerns etc...This forum has helped me a lot. At any rate, I have two questions: 1-You mention the "Wahoo" a lot after testing negative after three months for low risk activities -- ie. Oral Sex -- my question, however, is since this website recommends being tested at six months (Probably to cover their butt) and your recommendation is 3 months, how many cases have you seen where somebody tested negative after three months and then tested positive at 6 months? Are there statistics or information on this?

I think the important thing to remember, which of course you do, is that a lot of these statistics are based on what people are "Saying". What they are actually "Doing" to create these statistics is not testable.

Secondly, I have been having a lot of joint pain seemingly at the same time of my potential exposure. At 16 weeks, I tested positive by the Elisa and then tested Negative by teh confirmatory Elisa and WEstern Blot Test. I decided to go to another location to get tested again and that one was negative on the first time around. What can be understoond by this seemingly false positive test at 15 weeks. By the way, I had unprotected oral sex -- both receiving and "a little" giving to a sex worker. I don't know her HIV status.

Do I need to get tested again? The answer to this question is mostly based on the answer to the first question. You do great work! Donation coming soon! Jake

Response from Dr. Frascino

Hello Jake,

1. "Never-before-answered question about the window period???" Jake, this question gets asked and answered very frequently. Have a look at the archives. The advice I give is based on my understanding of the scientific medical literature (published medical studies) and my two decades of experience as a clinical immunologist, HIV/AIDS specialist and person living with the virus. I'll repost a recent question that contains a reference from the medical journal AIDS that addresses the window period question.

2. Oral sex carries a very low risk for HIV transmission. Your 15-week ELISA was a false-positive, as definitively demonstrated by your subsequent negative ELISA and Western Blot. I have addressed the potential causes of false-positive tests multiple times in the archives. Have a look if you need additional information. I do not feel you need additional HIV testing. However, the option to retest is always open to you.

Thanks for your donation!

Stay well.

Dr. Bob

WW's should read Nov 12, 2005

Dr Bob,

in my 3 months of worried well hell I read almost everything there is to read on HIV. I stumbled across an interesting article i think will help alot of WW's feel better. The article is one of the only studies I could find showing the increased sensitivity of "modern" HIV tests. Also they tested the first generation assay which home access uses (Organon Vironistika Microelisa). I myself used the home access test at 12 weeks and was skeptical of the results (negative)because it was first generation, and detects the IgG response rather than a third generation which can detect the earlier IgM response as well. Nonetheless, ALL tests were positive within 2 weeks of onset of ARS, including the newer first generation tests. It also looks retrospectively at the older test which were significantly less sensitive (p<.01), but still turned positive within 7 weeks of ARS. I think this study is a good indicator for the reasoning of shortening the window from the older 6 month rec to 3. Also it may make you feel a whole lot better if you tested before this 3 month mark. As a physician/surgeon myself I feel, from the literature on seroconversion available, a 6 week "modern" test may be VERY reliable for a person with a healthy immune system, and not on PEP. A 3 month test is still needed for deinitive results. The only thing about this study is there were only 8 patients in the non-PEP cohort.

What do you think? Have you seen anyone, aquiring infection through sex, seroconvert past 2 months with a modern test. Thanks again and keep up the great work, you really helped me through these past few months.

http://www.aidsonline.com/pt/re/aids/fulltext.00002030-200010200-00014.htm

Response from Dr. Frascino

Hi,

Thanks for your thanks and for the information provided in your post. Personally it's been many years since I have seen anyone seroconvert beyond three months! (We don't usually get tests prior to that.) I'm quite comfortable recommending that tests at three months or beyond are now definitive, except in rare cases with extenuating circumstances.

Congratulations on your negative test.

Stay well!

Dr. Bob



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