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significant public health matter?

Nov 19, 1997

Rick, thanks for your wonderful service! I have a question

that seems to have public health ramifications, so, I ask it

in a spirit of genuine concern. The CDC tells callers that there are only

2 recorded cases of seroconversion after the 6 month "window" and

Dr. Joel Gallant, on another Body web page, repeatedly states that

greater than 99.999% of infected people will test positive by 6 months

and that only a couple cases of seroconv. taking longer than 6 months

have been recorded. However, you suggest that all anyone can say about

seroconv. statistics is that 99% percent of infected persons will have

seroconv. by 6 months. Herein lies my concern: You and CDC/Gallant differ in

your characterization of post-6 month seroconverters by as much as one % point.

Although this may seem trivial, when dealing with large populations, would'nt

the difference suggest a large number of people could take longer

than 6 months. For example, if in any given year, about

20,000 people actually test positive for HIV (according to CDC stats.),

then the one percent which you suggest could take longer than

6 months equates to 200 people who may be infected.

Isnt this difference of a mere percentage point, when projected to

large populations, a significant difference? Which, then, is more correct

to say: that there are only a couple of documented cases (thus, quite rare),

or that about 99% of people will have seroconverted (leaving one to

surmise that 200 hundred a year could be unknowingly infected)?

Response from Mr. Sowadsky

Hi. Thank you for your question. If you read my answers regarding the accuracy of the HIV antibody tests, you will note it states, "The MAXIMUM period of time that an infected person will show positive on the test is 6 months. By this point in time, MORE THAN 99% of infected persons will show positive on the test. This is as accurate as any test in medicine could ever be..... At 6 months, the tests are MORE THAN 99% accurate."

You cannot just ignore the words "more than". There really is no conflicting information here. It is simply that different people are stating the SAME facts using different words. Sometimes people try to take things word-for-word, without realizing there are different ways to say the same thing. Let's not try to make things more complicated than they are! However you want to word it, be it "more than 99% accurate", "99.99% accurate", whatever, it all says the same thing. Simply put, it is extremely rare for a person to start testing positive longer than 6 months. That's it.

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).

colf/flu producing a false negative

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