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Anonymous
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Info about the 3 month window period
      #3842 - 05/09/00 06:43 PM

Im gonna post this info I gathered from this site nysna.org. This info is updated and have other links.

Definition of HIV "Window Period"
Has Changed

Based upon a clearer understanding of current scientific and clinical data, the Departments of Health (DOH) for the State and New York City have determined that the "window period" for HIV infection probably does not exceed one month in most cases. Therefore, it is now recommended that after exposure, the re-test should be at three months, rather than six months. This change will increase the likelihood for earlier treatment to begin.

Please see the below DOH memorandum for complete information. If you have questions, contact Nursing Practice and Services Program at extension 282.


--------------------------------------------------------------------------------

Update on the Window Period for HIV Infection
New York State and New York City Joint Recommendations for HIV Testing and Re-testing

What is the Window Period?

The window period is the length of time after infection that it takes for a person to develop enough specific antibodies to be detected by our current testing methods. If an individual engages in unsafe sex or shares drug injection equipment and becomes infected, the body will make antibodies to fight HIV. When enough antibodies are developed, the HIV antibody test will come back positive. Each person’s body responds to HIV infection a little differently, so the window period varies slightly from person to person. HIV is most commonly diagnosed in adolescents and adults through HIV antibody testing. However, there are also tests that diagnose HIV infection by detecting certain parts of the genetic material of HIV. PCR (polymerase chain reaction) tests are used to diagnose HIV infection in infants. Viral culture may also be performed in certain circumstances to diagnose HIV.

How Has Our Understanding of the Window Period Changed Over the Years?

Early in the epidemic, our testing methods were not as sensitive as they are today. Doctors and public health officials wanted to make sure that people who engaged in risk behaviors for HIV were tested long enough after their risk to be sure that anyone who was actually infected would test positive. The Centers for Disease Control currently states that people with possible exposure to HIV, who test negative, should be re-tested six months after the possible exposure to ensure that sufficient time has elapsed to make antibodies. However, as early as 1990, the Association of State and Territorial Public Health Laboratory Directors reached a consensus recommendation that virtually all seroconversions are complete within twelve weeks of exposure. Improvements in HIV testing technology over the last fifteen years, increasing laboratory experience with testing and the ability to better monitor early infection through PCR testing have contributed greatly to our understanding of the window period and have provided increased confidence that virtually all cases of HIV infection can be detected by three months.

What is the best time for the first HIV test after a possible exposure to HIV?

Most people infected with HIV will develop enough antibodies to be detected by our current HIV antibody tests four weeks after the exposure. This means that, for example, if a person had unsafe sex and became infected on January 1, it is likely that he/she will have enough antibodies to test positive four weeks later. If the person tests positive, this early testing is beneficial because the person can begin receiving medical care very early in the course of the infection. Recent advances in care and treatment for HIV infection have increased the advantages of early identification and treatment. Therefore, especially when HIV infection is highly suspected, it is often beneficial for the first HIV test to take place four weeks after an exposure. In cases of occupational exposure or exposure through sexual assault, an HIV test is also recommended immediately after the exposure to establish baseline HIV status, followed by another HIV test one month after the exposure (see MMWR 8/15/96 for details of CDC recommendations).

How long after a possible exposure to HIV does the person have to wait to be tested to be sure he/she is not infected?

It is possible that someone who tests negative four weeks after an exposure may be infected but his/her body has not had sufficient time to develop antibodies. Therefore, to rule out HIV infection, it is important to re-test three months after the exposure. It is extremely rare for an HIV-infected individual to not develop antibodies by three months. An individual who tests negative three months after an exposure does not require further testing unless he/she may have repeated exposures or if their antibody test results are incompatible with their clinical history.

What is the recommendation for testing for individuals who engage in on-going risk behavior?

The primary focus of our work with individuals who place themselves at on-going risk for HIV infection must be continued education, behavioral counseling and harm reduction, such as education about safer injection practices and referral to syringe exchange programs and drug rehabilitation services. HIV testing offers no “protection” from HIV infection. An individual with a negative HIV test who engages in on-going risk behavior should be offered testing every three months and counseled to avoid risk behavior. In these cases, the function of testing is to ensure early access to care in the event that the individual becomes HIV positive.

For more information about the window period, consult the following articles:

Bartlet JG. Serology and Baseline Laboratory Studies for Human Immunodeficiency Virus Infection Infectious Diseases in Clinical Practice, Vol. 4, No. 5, pp 334-42.

Busch MP, Lee LL, et al. Time Course of Detection of Viral and Serologic Markers Preceding Human Immunodeficiency Virus Type 1 Seroconversion: Implications for Screening of Blood and Tissue Donors. Transfusion, 1995 Vol. 35, No. 2, pp 91-7.

Lackritz EM, Satten GA, et al. Estimated Risk of the Human Immunodeficiency Virus by Screened Blood in the United States New England Journal of Medicine, Vol. 333, Number 26, pp 1721-25.

Report and Recommendations: Fifth Consensus Conference on Testing for Human Retroviruses, March 6-8, 1990; Association of State and Territorial Public Health Laboratory Directors



Send Association related comments and questions to: info@nysna.org
Send web site related comments and questions to: webmistress@nysna.org
Copyright © 1999 New York State Nurses Association
Last modified: March 09, 2000






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Anonymous
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Re: Info about the 3 month window period new
      #3846 - 05/09/00 09:17 PM

If this is recent then this is the best news ive ever read!



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Austin
Unregistered

Re: Info about the 3 month window period new
      #3848 - 05/09/00 09:29 PM

I got tested by the state department of health at 3.5 mo and 6.5 mo, and by a private lab at 4mo. All negative. The counselor at the department of health advised me, on the advisement of local HIV docs, that people who are truly recently infected with HIV start testing positive within a few weeks. Almost everyone, and she emphasized "everyone" will be positive by 3mo. In fact, she stated that 3mo was a conservative time frame. She stated that testing at 6mo was for peace of mind. She said that she witnessed numerous people who had had unprotected sex even one week before test reactive on the Elisa. The fact is that in a handful of rare cases will someone test positive after 3mo. If you are still concerned, get a viral test done and /or get a CD4 count for yourself just to obtain peace of mind.



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DUDE
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Re: Info about the 3 month window period new
      #3853 - 05/09/00 10:48 PM

Hi,
That's nice and all. . . but the CDC (Center for Disease Control) is a higher authority than the State of New York.
Here's what the CDC says:

The tests commonly used to detect HIV infection actually look for antibodies produced by your
body to fight HIV. Most people will develop detectable antibodies within 3 months after
infection, the average being 25 days. In rare cases, it can take up to 6 months. For this reason,
the CDC currently recommends testing 6 months after the last possible exposure (unprotected
vaginal, anal, or oral sex or sharing needles). It would be extremely rare to take longer than 6
months to develop detectable antibodies. It is important, during the 6 months between exposure
and the test, to protect yourself and others from further possible exposures to HIV.

The CDC National AIDS Hotline can provide more information and referrals to testing sites in
your area. The Hotline numbers are 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or
1-800-243-7889 (TTY).



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Anonymous
Unregistered

Re: Info about the 3 month window period new
      #3857 - 05/10/00 12:37 AM

I agree DUDE, the best thing to do, for peace of mind, is to test out to six months. That way you know it's 100% accurate. The three month test gives you 9.99999999999999% assurance. The only problem I have with waiting an extra three months is the reality of the situation. When you get a virus in your body, you produce antibodies right away. Unless you are already immune compromised, which you would know most likely anyway, your body is going to produce those antibodies. Why does everyone think that they are that rare case and have a rare body that will not show positive by 3 mo?



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Worried 2000
Unregistered

Re: Info about the 3 month window period new
      #3860 - 05/10/00 10:20 AM

I read that website too. It seems reputable. This makes me feel somewhat better.

But again, the website said testing a 1 and 3 months is good because it allows for earlier treatment. It does not necessarily mean that testing beyond 3 months isn't necessary.

I tested negative at 79 days. I will be going back this upcoming Monday. That will be 93 days. I hope and pray to God that everything is negative.

I hope and pray for the people on this board. I realize we will all almost certainly pull through, but I feel for you and all of us.

Keep the faith.



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Anonymous
Unregistered

Re: Info about the 3 month window period new
      #3861 - 05/10/00 10:58 AM

what is the web page address for this article?
Thanks



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Anonymous
Unregistered

Re: Info about the 3 month window period new
      #3865 - 05/10/00 12:39 PM

Indeed it is recent and updated. I think last update was in this year, the 2000. Anyway, just check out the website: nysna.org




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