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Donation sent
Jun 15, 2008

Hi Dr. Bob, This is Adam again. Thanks for replying. I will be traveling to South East Asia for a month in July. My question is that can I do the ELISA earlier (about 2.5 months) instead of 3 month? Does it have a big influence on the outcome of the result? I read somewhere that most people (96%) will show antibody 6 to 8 weeks after exposure. I have sent a check to your organization. Thank you again Dr. Bob.

Response from Dr. Frascino

Hi Adam,

Unfortunately, I cannot single-handedly change the HIV-testing guidelines. If I OK'd 2.5 months for you, can you just imagine the influx of "what about me?" posts that would inundate my already overstuffed inbox??? And so, Adam, what I can tell you is what I've told so many others before you (also asking similar questions about testing "early"): The published guidelines state that HIV-antibody testing done prior to the three-month mark is not considered to be definitive or conclusive. I can also tell you that the vast, vast, vast majority of HIV-infected folks will have detectable levels of HIV-antibody in their blood within 6-8 weeks of primary HIV infection. In addition I can also tell you some testing sites have shortened the HIV window period for their clients, based on data from the types of new-generation HIV testing they are employing at their test site. (See below.) Adam, certainly if you test negative at 2.5 months, your result would be extremely, extremely encouraging. That should give you piece of mind while traveling. You could get a follow-up rapid test when you return, if you want your guidelines-certified negative test result, OK?

Thanks for your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. In return I'm sending you my good-luck karma that your definitive HIV test result will be negative.

Good luck!

Safe travels Adam!

Dr. Bob

c'mon mate please help Aug 30, 2006

oh cmon doc,,,i really need ur help...this is my 3rd time askin...im unemployed so im unable to make a donation...im just a student!!!...well i live in sydney australia...and i had a six week test done at sydney sexual health centre it was negative ,,,the DOCTORS at SYDSEX said ur result is conclusive and definitive..i argued with them quoting ur website ,,,they replied back that the internet is full of trash,,,,and that the modern tests in sydney are conclusive after six weeks.......so than i went to a reputable doctor near oxford street,,,,he said yep after six weeks ur fine,,and that he wouldnt get anoher test.....please answer me ,,,i really need ur help ....ive been traumatised ...all this conflicting information!!!!.......the HIV hotline in sydney also says six weeks is fine with modern aussie tests....and mind u this is SYDNEY,,,a first class city where hiv has been around since day one.....but i stlll dont believe this six week crap...but they wont even retest me...... what the hell should i do bob!!!!...i really need ur opinion mate ,,please answer me this time...whats the matter u'VE lost love for us aussie boys??....trust me ,,us aussies have lost no love for u...

cheers - RAT

Response from Dr. Frascino

G'day RAT,

Moi? Lose the love for spunky Aussie jackaroos??? No way, mate!

I'm well aware of SYDSEX's recommendations. I'm also aware other countries' guidelines state six months in their guidelines. And there are some physicians who put the window period out to one year and beyond! The three-month guideline is the most universally accepted and I still believe, based on all the epidemiological studies, it's the most reasonable universally. Yes, it may be somewhat conservative in light of the improvements made in HIV screening (3rd and 4th generation assays, etc.); however, not everyone worldwide has access to these newer tests, but everyone does have access to what I post here. Also, no matter how good the test assays may be, there is still host variability. That means not everyone's immune system behaves in exactly the same manner. Some may take longer to produce detectable levels of anti-HIV antibodies for a wide variety of reasons. Consequently, my recommendation, at least for now, remains that tests taken prior to three months are not considered to be definitive and conclusive.

That said, I'm quite confident the six-week test in Sydney is indeed accurate, and I would not argue with their recommendations for folks getting tested there; although, there are extenuating circumstances in which I personally would extend the testing period (hep C coinfection, significant occupational exposures, etc.).

Finally, the option to retest is always open to you, although you may need to pay for the test yourself, if your health plan refuses to cover it.

OK, banana bender, are we mates again? As always my affection for you guys stands out like a shag on a rock.

By the way, some Oz organizations would even like to shorten the six weeks window! See below.

Ciao bella,

Dr. Bob

Window period. Aussie policy.

Jun 13, 2006

Hi Dr Bob.

Just thought I'd share this with your readers. This is the current policy from ANCARD (Australian National Council of AIDs and Related Diseases). The passage below was taken from the 'Clinical Screening and Case Detection' section. Where there is reasonable concern about the risk of HIV infection, a patient with a negative test result should be retested one to three months after exposure or a specific event, and retested if there are clinical signs or symptoms. The seroconversion window period ranges from two to six weeks after infection (Schreiber et al., 1996). To identify very early infection, p24 antigen or nucleic acid amplification testing may be carried out. I found another officaial Aussie site that also suggested that when using current testing methods, one month is adeqaute to allow for detectable antibody production. I see that your 'New York Health Department' site also concedes that one month is ample time in almost all cases of seroconversion. Hope this helps ease the minds of some WW's out there.

Response from Dr. Frascino

G'day Mate,

Thanks for the information!

Dr. Bob



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