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HIV Transmission and Education >> Am I Infected?

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Worried 2000
Unregistered

The > 6 Month Window Period
      #4837 - 06/03/00 04:16 PM

The post by Taz made me worry a little bit. Here is what Joel Gallant at Hopkins has to say about 6 months (and keep in mind that most people think the same about 3 months, on this board, at least, it seems):

Q: Dear Dr,

My doc thought I might have HIV after a recent 3 week illness involving the high
fever, extreme fatigue, weight loss, flooding nite sweats. I didnt take the PCR test
yet but initial ELISA antibody test is negative at 3 months. Should I continue to take
the ELISA if my 6 month ELISA test is still negative, and do you recommend the
PCR test too?

Thanks
Rodger


A: Rodger,
If a doctor thinks you might have HIV because of symptoms consistent with the
acute retroviral syndrome, then the most appropriate test is a PCR. The PCR is less
useful, however, once those symptoms have resolved. A negative HIV serology at 3
months is very reassuring, but a follow-up test at 6 months is advised. You do not
need further testing if you are negative at that point


Q: Why don't you recommend that people who can afford it/have insurance that will
pay for it use the DNA PCR test instead of the ELISA test for detecting hiv?
Doesn't the DNA PCR test allow for earlier detection and thereby give infected
people the opportunity to start treatment earlier which you have noted could be
more beneficial to them in the long run. Also, isn't the DNA PCR test always going
to be positive in someone who has hiv regardless of the level of their viral load? So,
false negatives wouldn't be an issue as they are with the ELISA test. Thanks for
your time.


A: The DNA PCR assay is extremly sensitive (more than 99%) at picking up HIV
infection when it's there, and it can detect HIV earlier than serology. However, the
specificity is only about 98% (compared to >99.9% for routine serology). That
means that if you tested 1000 people who didn't have HIV, 20 would turn up
positive using this test.

In short, the DNA PCR is a good test to use if the clinical suspicion for acute
retroviral syndrome is high (suspicion on the part of the doctor, not the patient). But
in low risk people--the kind most likely to obsess about the possibility of having
HIV infection--the DNA PCR test is not the most appropriate test. It will lead to
false positive results that will only increase the level of anxiety and confusion.

Q: You recently answered a question stating that it it rare for
a person to take longer than 6 months to develop antibodies,
but there are a handful that have taken longer. How many is a handful? Were there
any common factors among this handful? What is the longest it's taken ?

Thanks


A: Maybe it's less than a "handful"... I'm aware of one case in which a healthcare
worker who was occupationally exposed seroconverted at 11 months. I believe that
this was the longest delay in seroconversion reported to the CDC. No doubt there
are individuals who feel that they had a similar or longer delays in seroconversion,
but usually they can't document the time of infection the way this healtcare worker
could. Seroconversion occurs within 5.8 months in close to 100% of cases.

Finally, I get a half dozen questions a week asking me "How good is the test at 2
months?" or "6 weeks" or "70 days," and it's getting ridiculous. There's no answer to
these questions. If you're negative at 3 months, you're most likely negative. If you're
negative at 6 monhts, you're negative. End of story.

There have been one or two cases in which seroconversion took a tad longer than six months. The chances are greater that you'd get hit by a car on the way to your nine month test than that you'd test positive after having had a negative test at six months. Life is full of too many real and common crises to be worrying about the ones that are next to impossible.




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Anonymous
Unregistered

Re: The > 6 Month Window Period new
      #4838 - 06/03/00 04:20 PM

all i know is that tax's post did scare me. we got people now who need more than 6 mos to test positive. there sill always be a chance that i am one of those people. this scares me greatly. why didn't i just wear a condom the first time? does anybody else out there worry like this? what if i am the one person who needs more time? how likely is that? i can't handle these feelings. i am really starting to go crazy! is there anybody out there who can help me think about this? thank you so much for sharing



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DUDE
Unregistered

Re: The > 6 Month Window Period new
      #4839 - 06/03/00 04:25 PM

Thanks worried 2000, those are the posts we need here to keep people sane.
As for the post after that, the guy needs some professional counseling. He didn't read the post did he. More likely to get in a car accident or see a UFO than to test poz after six months.
DUDE



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Worried 2000
Unregistered

Test Friday new
      #4841 - 06/03/00 04:36 PM

Dude - - -

I know you said you're going to test this Friday. As Friday is also 4 months (17 weeks) for me, I figured I'd go in and get another test as well. The results should be ready by Tuesday or Wednesday.

Let's keep our fingers crossed.

As for those 1-2 people that need > 6 months, all I can say is what Gallant said--you gotta not worry about these kinds of incidents and accidents. It is true--without doing what I did, I'd never have to worry about it. Know, there's always a chance. But sooooo small.



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Anonimous
Unregistered

Re: The > 6 Month Window Period new
      #4845 - 06/03/00 09:30 PM

And even like the CDC has said, most likely to get struck by a lightning or win the lotto than test positive after a negative 3 months test!



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Anonymous
Unregistered

Re: Test Friday new
      #4846 - 06/03/00 09:33 PM

Its your decision Worried 2000 but I think youre wasting your time testing over and over again. Perhaps, so that you are going back to get tested you could get some more of that good info you always bring here to us.



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Anonymous
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Opps! I didnt want to make that icon. Sorry! new
      #4847 - 06/03/00 09:35 PM

You have to be happy! :)



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Taz
Unregistered

Re: The > 6 Month Window Period new
      #4849 - 06/03/00 10:49 PM

It wasn't my intent to frighten or worry anyone by my earlier post and I apologize if it did. I'm a firm believer that 99% of infected people will test positive at 3 months and 99.9% at 6 months. However, there are those EXTREMELY rare cases of people who need longer to test positive. But you have a better chance of being struck by lightning or winning the lottery than you do of being one of these people. I think it would be crazy to worry about such stratospheric odds and I certainly don't.

All I was trying to say is that each person should continue to test until they feel comfortable in accepting their results. The Canadians want to test out to 3 months because that's what their government says; DUDE wants to test out to 6 months because that's what the CDC says.

The bottom line is that your results are NEGATIVE! If you can move on, then more power to you. But don't attack or disparage somebody else because they want to do another test -- that's entirely their choice.

Take care.




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DUDE
Unregistered

Message to Worried 2000 new
      #4853 - 06/04/00 02:24 AM

You have my sincere best wishes on your test Friday. I'm not testing for another 10 days or so. I got one of those HOMEACCESS kits. It takes about 2 weeks to get the results. It's the same ELISA test used by the labs.
Anyway, I wish you the best. It sure is messy on this board sifting through fact & fiction isn't? Trying to keep the information on target has been difficult. I guess I'll have to post some old stuff again for the new-bees.
Best wishes again. This test Friday is for 3 or 6 months, or 4.5 months?
Also, when I test, I'm gonna give you my e-mail to chat about some other issues. I haven't had any sex since this crap and got a fear about getting involved now. Anyway, that's for another day.
Beest wishes. . . .
DUDE



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