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Tests for HIV Subtype O (GROUP O, Subtype O, 2010)
Jun 25, 2010

Nine months ago I had a sexual encounter with a West Africa prostitute whilst abroad. This encounter involved me receiving unprotected oral sex (flaccid), followed by masturbation and come. There was no penetration, however there was alcohol involved and I believe I may have transferred vaginal fluids from the woman to the tip of my penis as I ejaculated.

One week later I developed flu like symptoms and tingling in the testicle area. I have since been test for all STD and HIV 1 and 2 on 3 occasions as I believed it could have been via this contact. Tests were normal antigen tests, MEIA, ELISA and finally Western Blot. All gave negative results. The last test was by immunology dept at hospital, where they completed a CD4 and viral load test. I was told there was no indication of any infection. However I am continuously fatigued, muscles in arms and legs are notably weaker and very stiff on a daily basis. I have continuous tingling in my arms, hands, legs and feet (worse with exercise) and still experience daily tingling in testes and in my jaw area on my face. I also lose feeling in my arms frequently while in bed at night, which appears to be via impacted circulation. I also have increased imprinting on legs, I believe is called edema.

Do you think there is any possibility that this could be a HIV subtype O which has been undetected by all these tests. I am currently having councelling to discuss the overall issues, but would appreciate some expert advice on this issue. I have seen some previous responses regarding subtype O on your site, but not with direct contact with someone from the area the subtype has originated from.

Regards

Steve

Response from Dr. Frascino

Hello Steve,

Your HIV-acquisition is extremely low. I would very strongly doubt you have subtype O infection, even though it is endemic in West Africa. Should you continue to worry, subtype O screening is now available (see below). I'm pleased to read you are getting counseling, as I'm quite confident your symptoms are related to anxiety, not HIV.

Good luck. Be well.

Dr. Bob

Patient require your help!!! (GROUP O, Subtype O, 2010) Jun 19, 2010

Hi, doctor Robert J Franscino

My name is Deepak . I am MD, Internal medicine. I am from New Jersey. One of my patient is going through severe anxiety and depression. He tested Positive on Labcorp ICMA test for Hiv 1/O/2 but negative on western blot. I have assured him so many times that positive ICMA with Negative western blot is HIV negative test but he doesnt wanna believe me. He also had ELisa or EIA which was negative. He had several viral load test done which were undetectable. He keeps coming to my office every week. Last time he was here he told me that he might be infected with HIV 1 group o type. I am not sure about that and that why I am seeking your help. I thought HIV 1 Group o is extremely rare in USA.

Specific Questions:

1. Do you know of any case registered with HIV 1 Group o infection in US?

2. Now he is starting to worry me because I am his family doctor. I have not revealed anything to his family yet. is he really free of Hiv?

3. I hope I am not bothering you with too many questions. whenever you will reply back I would like to print this and assure him again that I did seek professional's help. I hope its ok to print your statement.

Thank you very much for taking time to reply.

Sincerely, Deepak , MD, Internal Medicine

Response from Dr. Frascino

Hello Deepak,

No, not personally. See below for additional information about Group O and Group O testing.

Yes, your patient is HIV negative. His problem is psychiatric, not virologic. I would advise you refer him to a psychiatrist to help him confront his irrational fears of being HIV infected.

Absolutely.

You're welcome.

Dr. Bob

lost cause (I KNOW I HAVE IT 2010) Feb 14, 2010

if it wasnt for this lipo crap i could move on with my life. i am turning into one to thos people that goes on and on about hiv for like ten years. i just never thought i would get lipo . its so hard to look at my elbows. and wrist. my bones are popping out. something i have to deal with. i guess im so stressed out that i caused this. i have been eating but no weight gain there. i hope your right about me. no way no how you got hiv!. i will still try to get tested for hiv group n and o. its hard to found that test. well take care, p.s i still have that swollen lymphnode behind my left ear. the doctors says its small dont worry about it . will i ever stop. see ya bob

Response from Dr. Frascino

Hello again jon,

Will you ever stop??? Good question! Will you???

You don't have HIV-1. You don't have HIV-2. You don't have group O or group N or undiscovered XYZ either. (I just made those up. Don't start worrying about them!)

Regarding group O testing, you could get an Abbott RealTime test. It's among the most sensitive viral load tests available. It has demonstrated the ability to detect diverse group M subtypes of HIV (including all known non-B subtypes) as well as group N and O isolates. I'm not recommending you actually need, or that you should get, this test. I'm merely being a nice guy and helping you with your Internet research on a disease that you could not possibly have.

Dr. Bob

group o Jan 22, 2010

hi .

its hiv group o. im pretty sure. that is what is causeing the lipo, and its not showing on the test. i did test for hiv 1 and 2 , but not o. i just now did test for group o. please tell me what you think. i would like to know why you do not think its hiv group o. waiting for your answer. thanks jon

Response from Dr. Frascino

Hi jon,

I'm assuming since HIV-2 didn't pan out, you're now fixated on group O. I guess that shouldn't come as a surprise to anyone who's followed your angst-filled story to date. (See below.)

Why don't I think you have group O? Primarily because I doubt you schtoooped a person from either Cameroon or Gabon.

Dr. Bob

Test Again? (TaqScreenMPX) Jan 3, 2009

I had unprotected insertive oral sex with a pro back on 9/23/05. 2 weeks later a whole constellation of very suggestive symptoms appeared but tested Neg. out to 22 months using every test possible. I happen to be reading the news today about a new FDA approved test that will finally pick up type "O" strains that are increasing in the US. Test called TaqScreenMPX. What are your thoughts on retesting? Would the older tests still have picked up on the strain weakly or perhaps not at all?

Response from Dr. Frascino

Hi,

I see no reason for retesting and would consider your negative results definitive and conclusive. Please note the Taq Screen MPX test is FDA approved to screen donated blood to increase the safety of the blood supply. It is not intended (or approved) for use in routine HIV screening or HIV diagnosis. (See below.)

Dr. Bob

FDA Approves Most Comprehensive System to Test Donated Blood for HIV, Hepatitis B & Hepatitis C

Advanced test for increased blood safety is first to add the detection of HIV- 1 Group O RNA and HIV-2 RNA

PLEASANTON, Calif., Dec. 31 /PRNewswire/ -- The United States Food & Drug Administration (FDA) today approved a new nucleic acid test from Roche to screen donated blood for HIV-1 Group M RNA, hepatitis C RNA and hepatitis B DNA in a single, automated assay. The test, called the cobas TaqScreen MPX Test for use on the cobas s 201 system, is a qualitative in vitro test for comprehensive single-assay detection of HIV-1 Group M RNA, HIV-1 Group O RNA, HIV-2 RNA, hepatitis C Virus RNA and hepatitis B Virus DNA in human plasma. The test, WHICH IS NOT INTENDED FOR USE AS AN AID IN DIAGNOSIS,is designed to further increase the safety of blood supplies by identifying infections earlier than traditional serology tests.

"Roche is committed to meeting the needs of blood centers with tests and systems that ensure the highest blood safety," said Daniel O'Day, head of Roche Molecular Diagnostics, the business area of Roche Diagnostics that developed the test. "Our multiplex test has been widely adopted and has demonstrated excellent performance in blood centers worldwide. We are pleased to introduce it in the U.S. as we continue to further invest in solutions for this critical industry."

The test runs on the fully automated, real-time PCR cobas s 201 system, designed to increase processing efficiency with a unique modular design and ready to use reagents.

"The Roche MPX test raises the blood industry to a higher level with regard to overall blood safety, process simplification and process control," said Louis M. Katz MD, Executive VP, Medical Affairs at Mississippi Valley Regional Blood Center, one of the TaqScreen MPX clinical trials sites. "Our organization looks forward to using the MPX test."

Countries that have implemented NAT testing have demonstrated a reduction in transfusion-related HIV, HBV, and HCV infections. In the U.S. alone, the Centers for Disease Control and Prevention estimates that there are more than one million people in the U.S. living with HIV/AIDS, with an additional 40,000 people being infected each year. It is estimated that 300,000 infected persons are unaware of their HIV status. More than 4 million people in the U.S. have been infected with HCV, 3.2 million of whom are chronically infected. HCV is the leading cause of liver cancer in the U.S. More than 1,200,000 people are chronically infected with HBV and about 5,000 people die of complications of HBV every year in the U.S. Many individuals with HBV and HCV show no symptoms of disease, and do not know that they are infected.

About Roche Blood Screening

Roche Diagnostics is the leading provider of real-time PCR-based nucleic acid tests for the international blood bank market. Nucleic acid-based tests

enable earlier detection of active HIV, Hepatitis C, and Hepatitis B infections than conventional antibody or antigen assays. Roche assays have been used by the Japanese Red Cross since 1999 to screen Japan's entire blood supply. Roche launched the automated cobas s 201 system and the cobas TaqScreen MPX Test outside the United States in 2006 for the most comprehensive single-assay detection of HIV-1 Groups M & O, HIV-2, and hepatitis B and C in donated blood and plasma. The West Nile Virus test for this platform was launched in the U.S. in 2007.

About Roche

Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As the world's biggest biotech company and an innovator of products and services for the early detection, prevention, diagnosis and treatment of diseases, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is the world leader in in vitro diagnostics and drugs for cancer and transplantation, and is a market leader in virology. It is also active in other major therapeutic areas such as autoimmune diseases, inflammatory and metabolic disorders and diseases of the central nervous system. In 2007 sales by the Pharmaceuticals Division totaled 36.8 billion Swiss francs, and the Diagnostics Division posted sales of 9.3 billion francs. Roche has R&D agreements and strategic alliances with numerous partners, including majority ownership interests in Genentech and Chugai, and invested over 8 billion Swiss francs in R&D in 2007. Worldwide, the Group employs about 79,000 people. Additional information is available on the Internet at http://www.roche.com.

All trademarks used or mentioned in this release are legally protected by law.

What is an eHIV test:? (GROUP O, Subtype O, eHIV TEST, 2009) Jul 17, 2009 I just received my HIV test results - Nonreactive. Yay! My question is about what is written on the results sheet. It says "Attention: New enhanced methodology (eHIV) detects antibodies to HIV-1, including Group O, and/or HIV-2.

Can you please explain what this eHIV methodology is? Also, what is Group O?

Thank you!

Response from Dr. Frascino

Hi,

WOO-HOO!

The eHIV test is an "enhanced" automated assay for HIV-1, HIV-2 and HIV subtype O. It was FDA approved in June 2006. The "enhanced" aspects are largely technical improvements, such as cascade reflex testing. I'll print some information about the assay below.

As for "group O," this refers to HIV-1 subtype O. The strains of HIV-1 can be classified into three groups: the "major" group M, the "outlier" group O and the "new" group N. Group O is found primarily in west-central Africa. Group N was discovered in 1998 in Cameroon and is extremely rare. More than 90% of HIV-1 infections belong to HIV-1 group M.

Dr. Bob

Enhanced Automated Test (ADVIA Centaur EHIV) Detects HIV Types 1, 2, and Subtype O

On June 21, the FDA approved an enhanced in vitro diagnostic immunoassay ( EHIV, made by Bayer Healthcare Diagnostics Division, a subsidiary of Johnson & Johnson) for use on the company's ADVIA Centaur system in the qualitative determination of antibodies to human immunodeficiency virus (HIV)-1, HIV-2, and HIV-1 subtype O in human serum and plasma.

According to a company news release, it is the first fully-automated test with this antibody range and meets worldwide healthcare standards for detecting all known types of HIV infection.

Advanced features provided by the enhanced HIV (EHIV) testing process include automatic algorithm processing, cascade reflex testing, user-defined panels, and automatic repeats of critical samples. Combined with use of sample tips and assay verification processes, use of the assay is expected to increase laboratory testing efficacy and security.



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