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Canuck fan again, let me know what you think of this.
Apr 12, 2007

Please Tell me what you think about this. I have read on another site that a man by the name of Doctor Handsfeild was at a conference where 300+ h.i.v. experts were asked if they had seen a negative 8 week test go on to test positive in the last 5 years, and not one of them had! These are people that deal with h.i.v. patients every single day. Now, I read a post of yours where you say it has been MANY YEARS since you have seen a 3 month negative turn positive. Now, why do you think that some physicians still reccomend following up at 6 months to healthy people? I understand there is a chance of taking longer to seroconvert, If you have recently undergone chemotherapy and are being treated for cancer with a compromised immune system, or have Hep C but heres something to think about: The only way for the doctor to know how long it took you to seroconvert is by you telling them when your exposure was. SO think of this. A girl cheats on her boyfreind and finds out later she has h.i.v., she insists to him, and to the doctor and everyone that she was exposed to it 6 months ago (before they were together) to try and keep him. I am sure this has happened many times, basically the patient lying about when her exposure was to cover her ass. I really believe that there must be people that have done this, and as a result, The CDC has been informed of a 6 month seroconversion, This makes me wonder if testing beyond 3 months is ever necessary for someone who is healthy?

Response from Dr. Frascino

Hello Canuck,

You correctly point out one of the major problems in trying to unravel this conundrum, that being how do we accurately document the date of exposure when doing epidemiological/observational studies on how long it takes someone to seroconvert? There is general agreement and sound evidence to support that the vast majority of HIV-positive individuals will have detectable levels of anti-HIV antibody in their blood within six to eight weeks of exposure. You have pointed out some of the confounding conditions that may delay antibody production. There are others as well. Not everyone's immune system functions with the same efficiency or integrity. Consequently, some may lag behind "the vast majority" in developing a robust anti-HIV antibody response. With improvements in HIV testing techniques, I am now quite comfortable in recommending the three-month mark as definitive and conclusive for most "routine" potential HIV exposures without extenuating circumstances. Some organizations have adopted a six-week standard. The CDC is moving toward the three-month recommendation, but continues to recommend a follow-up test at six months for a "significant" HIV exposure, including occupational exposures. The ultimate purpose for the guidelines is to try to make sure no HIV infections are missed due to the potential catastrophic consequences a "false negative" test might engender. In other words, the guidelines err on the side of caution. Hope that helps clarify this ever confusing situation.

Dr. Bob



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