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Not_scared
Unregistered

18 MONTHS TO FIND OUT latest ELISA tests
      #6875 - 07/09/00 01:12 AM

It took me over a year and a half to figure out all the baloney that I was being fed from different doctors and clinics. They were giving me all kinds of misinformation about the different generation ELISA tests. To cut through all the medical babble and not waste time arguing with your doctor or the clinic, ALL ONE HAS TO DO IN ORDER TO RECEIVE THE LATEST ELISA TEST IS SIMPLY TO SAY, "PLEASE GIVE ME THE HIV 1/2 ANTIBODY TEST, PLEASE!" All combined HIV-1/HIV-2 antibody tests MUST employ either synthetic peptides or recombinant DNA sources for their antigens. This way you avoid all the confusion about whether your HIV-1 test is the latest generation. Most of the straight HIV-1 tests are first generation ONLY! I am saving everyone tons of time and aggravation, believe me.
If you call the national number that the CDC gives you for testing (800-584-8183), they try to sell you for $97 (last time I called) a straight HIV-1 test claiming it's third generation. IT IS NOT! They try to hide the fact that for about $20 more, they offer the HIV 1/2 combo test, which is worth EVERY penny more, because instead of having to wait six months to be 100% sure, you can have the same level of certainty at just 12 weeks. (by the way, Home Access also has an 800 number so don't confuse this with what I am talking about; Home Access only offers a 1st generation test but at least it's only $40 or so) ) The 800-584-8183 place is making such a killing by only "openly" offering the older HIV-1 test only. This 800-584-8183 outfit offers the DNA PCR test, and also mention their antibody test (the HIV-1 of course), without mentioning that the HIV 1/2 test is also available. Don't waste the effort (and trauma of getting your arm stuck with a needle) unless you are getting the latest generation HIV 1/2.
This 800-584-8183 place won't give you a hassle about the HIV 1/2 test like your own doctor might because they want the business. You see, most doctors will say, "hey, you didn't go to Africa or have sex with a West African so don't waste your extra money on an HIV-2 test. It's not necessary," he/she will tell you. Again, it's not the HIV-2 that is the issue; it's the generation of the test you want to be the latest. And the HIV-1 part of the combo HIV-1/HIV-2 test will be a recombinant DNA or synthetic peptide 3rd generation test. THAT'S WHAT ALL THE FUSS IS THAT I AM TRYING TO MAKE!!!
Finished_Worrying!



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Bullshit
Unregistered

Re: 18 MONTHS TO FIND OUT latest ELISA tests new
      #6876 - 07/09/00 01:47 AM

This post is absolute bullshit. Any clinic or hospital in the United States uses the most up to date tests available. Nobody is using the same types of tests today that they used 12 years ago.

If you are in an urban area, you are getting tested by quality tests that are as accurate as any mentioned in this post.

Please don't post these kinds of things; all they do is spread misinformation.



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Anonymous
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Re: 18 MONTHS TO FIND OUT latest ELISA tests new
      #6877 - 07/09/00 01:59 AM

good thing you say its misleading. i was about to have a heart attack.



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Worried 2000
Unregistered

Re: 18 MONTHS TO FIND OUT latest ELISA tests new
      #6893 - 07/09/00 03:41 PM

I think this post is bullshit too. A test you get anywhere in the United States is going to be done using the best technology available. Talk all we want about third generation and so forth, but the bottom line is that even if it's a first generation test, it's greatly improved from where it was 10 years ago.



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Not_scared
Unregistered

Re: 18 MONTHS TO FIND OUT latest ELISA tests new
      #6895 - 07/09/00 05:51 PM

Duh! Obviously, the reagents have been updated since 10 years ago (ask Dr. Frank, the Medical Director of Home Access). Boy, I have to remind myself that I went through a science degree and 98% of people don't have science degrees. OK, Mr. "Bullshit", tell me the facts that all the labs use the latest tests. Do they use viral lysate like they did in 1985 in our year 2000 first-generation tests? YES. Have they tweaked those viral lysate first-generation tests so they are better than 10 or 15 years ago? YES But are they as analytically sensitive as 3rd generation ELISAs? NO NO NO (like me, you should get a microbiology degree you moron)



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Not_scared
Unregistered

Re: 18 MONTHS TO FIND OUT latest ELISA tests new
      #6896 - 07/09/00 06:24 PM

Hey, the poster calling him/herself, "bullshit", what do you have, a journalism or child psychology degree? Go talk to Dr. Frank, Medical Director of Home Access. Or try Jon Kaye, M.D., Ph.D., of Organon Teknika, which manufactures 90% of the Vironostika FIRST GENERATION viral-lysate (antigen source) HIV-1 test kits for 90% or more of the public health departments in this whole country.
GUESS WHAT? Vironostika is a First generation ELISA you knucklehead. Are they updated as far as their reagents? YES Better than 12 years? (duh) YES
Are they theoretically and practically limited in analytical sensitivity compared to 2nd and 3rd generation ELISA which use synthetic peptides and Recombinant DNA? YES
IMPLICATIONS: 2nd and 3rd generation tests can and do shorten the window testing period (you knucklehead) over the vast majority of the tests offered at most public health departments and clinics which, like I said, use the Vironostika 1st generation test in 90% of the time. New York is the exception; perhaps San Fran and Miami also use 2nd generation (synthetic peptide source of antigens) or 3rd generation ("sandwich type assay"). Apparently, high risk areas do use the more sensitive tests. I called Epitope, maker of OraSure oral saliva test: Also use 1st generation test. Orasure's manufacturer's are NOW pushing for FDA approval of a SECOND GENERATION ELISA TO ANALYZE THE SALIVA SAMPLES COLLECTED WITH THEIR SALIVA TEST KITS.
An exception: New York state and New York city labs are an exception: they use the second-generation synthetic peptide based HIV 1/2 tests (again, my point about getting the combination HIV 1/2 test!). NEW YORK STATE IS THUS ABLE TO RECOMMEND (if you test at their sites) that you don't require further testing past 12 weeks. I'll find out the manufacturer of New York State HIV-1 test kits. I once was told but forgot. if you are interested you can e-mail me at Lrez5@aol.com and I will find out the name for you.
I won't bother to post here anymore... TOO MANY SCIENCE-PHOBES ON THIS SITE!!! (especially the knucklehead calling herself/himself "Bullshit"). Try taking 4 years of microbiology and biotechnology coursework and graduate summa cum laude. Not the easiest thing I've ever done.
Something you could never accomplish, knucklehead! It sounds like you are verbatim repeating the mantra of Rick Sowadsky who has to stick to a consistent line about this testing to avoid confusion. Not trashing Rick though overall he's good.



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Anonymous
Unregistered

Re: 18 MONTHS TO FIND OUT latest ELISA tests new
      #6897 - 07/09/00 06:30 PM

Who cares how much you improve a 386 computer. If it's a 386, it's still a 386 even if you primp and tweak all around its main CPU. A Pentium is inherently going to beat a souped up 386 anyday! The basic architecture has limitations just like the limitations of a 1st generation ELISA test. You can improve it's reagents, but its principle design (which makes it a 1st generation test) cannot change. The Rick Sowadsky is referring to the fact that all antibody tests are accurate, given that you are past the 6 month window period. Less than six months, and to be sure you need a 2d or 3rd generation test to achieve analytical sensitivity which is a different concept than accuracy, knuckleheads.



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Anonymous
Unregistered

Not sure I agree with the post new
      #6907 - 07/09/00 09:58 PM

Regarding the earlier points about how nobody uses 3d generation tests except special labs . . . . my question is, then, why do lots of places go around saying that a test at 3 months is accurate? . . . . . These places are not all in New York City either . . . . . Places like Madison Wisconsin say it . . . . . John Hopkins says most tests will pick it up at 21 days . . . . . etc.

What about everywhere else in the world that says 3 months? Are they all using 3d generation tests too?

Finally - - - if you call that 800 number that was posted earlier, that place tells you that their test for $97 is conclusive at 3 months. . . . They don't say "our HIV 1 / HIV 2 test is conclusive at 3 months." They say that the $97 standard test is conclusive.

I think the point is that the 1st generation tests have been improved to the point that -- at 3 months -- they are as accurate as the 3d generation test . . . . . Maybe the 3 month test is more accurate/sensitive in the earlier weeks, but I think everything is fine at 3 months or more. . . .

Even the CDC says the average time to seroconversion and testing positive is 25 days . . . . Now, given its conservative tendencies, I doubt the CDC would say that it's 25 days if it meant 25 days ONLY if you are using this 3d generation test that the scientist claims is available only occasionally.

Bottom line: A test at 3 months is almost definitive anywhere you go. Before then, it may be up for grabs, but I don't think so. Past 6 weeks and you should feel good.

If you can't wait, get a PCR test at one month.



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Chris
Unregistered

TO: Not_Scared new
      #6908 - 07/09/00 10:10 PM

What are your thoughts on testing at 3 months, regardless of the type of Elisa test? In addition, do you have thoughts about the accuracy of a PCR test?



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Not_scared
Unregistered

3 Mos. Conclusive in NY new
      #6909 - 07/09/00 10:52 PM

I think that "800" number (800-584-8183) place needs to be sued by the Federal Trade Commission or the Attorney General's office (I'm not a legal expert so whatever govt authority that can bring an action for consumer fraud against a commercial enterprise). OR at least they did a few months back when their HIV-1 (not HIV 1/2) antibody test cost $89 dollars and turned out to be a Vironostika test kit at my local QUEST (formerly SmithKline Beecham Laboratory) LABORATORIES. I don't know if their present $97 test is the combined HIV-1/2 test; maybe someone with a little bit of smarts like me did complain to the FTC or whoever and the 800 number place ceased their lying and misrepresentation and are now offering a 2nd or 3rd generation test (which an HIV-1/2 combo test is by default).
Now, listen carefully: this 800 number place only claims on their tape that their PCR Proviral DNA test is conclusive in four weeks (and costs almost my whole weekly net paycheck for the test!. NO MENTION THAT THEIR ANTIBODY TEST IS CONCLUSIVE IN THREE MONTHS. Oh yes, when you talk to their personnel over the phone they will tell you that a three month antibody test is conclusive at 3 months (if you're healthy and normal and not on chemo) BUT THEN, when you go down to QUest Labs (or wherever they send you, like SKB labs), you find out you are getting the Vironostika 1st generation test kit if you ask the phlebotomist to see his lab manual index which I was crazy enough and thorough enough to ask to see. He admitted that it was a first generation and the Quest Labs in Teterboro, NJ, where they actually do the ELISA, confirmed this.
So the guy or woman at the 800 number is pulling your leg unless you ask for the combo HIV-1/2 test which is by default more sensitive and has to be sent to California (even though you may live on the East Coast) for the third generation ELISA (I called California and they claim that they use a recombinant DNA source for their antigen source--NOT VIRAL LYSATE like the 1st generation test).
Just so I don't get sued by the 800 number place, I want to point out this was the case about 6 months ago so, like I said, they may have cleaned up their act. Even as Mr. Bullshit posted above, urban areas (not all!!) do offer the latest generation test (I LOVE NEW YORK! and it's free although it may not be anonymous anymore--not sure). You have to do a lot of digging to find out though!! They can bullshit you all day long down at the clinics and health departments and even doctor offices until you talk to the guy in the HIV lab actually pipetting reagents into your blood sample!!! I got the lab tech to send me a copy of his test kit manual. I was tired of all the baloney I was being fed and finally got to the bottom of this charade. He said some labs went back to the first generation from the second generation because they were reacting too readily!! They didn't want to be bothered with running so many Western Blots he said (this was the lab tech at the SmithKline Beecham Laboratories).
The "800" number place is misleading a lot of people if they are only using first generation tests because I called the New York State Dept of Health headquarters in Albany New York, home of the "3 months is Conclusive" stance, and they said in my communications with their medical director that they can only take that stance if you use their ELISA testing system which is a double ELISA plus WB if reactive. They use a synthetic peptide 2d generation test and they tell you not to come back for another test at six months. IT'S NOT NECESSARY THEY SAY. So you can stop worrying if you get a negative HIV-1/2 at three months and it's a 2d or 3rd generation test like N.Y.
Again, I don't know any clinic that offers HIV-1 tests that are later than the first generation design, even with updated reagents. Somebody LET ME know if they find an
HIV-1 test (NOT a combo HIV-1/HIV-2 test) that is 2nd or 3rd generation.
All my medical information on what constitutes a 2d or 3rd generation test is published in an article by Bush et al who made up the Seroconversion study panel and was published in the journal "Blood" in 1995. I'll find the reference and you can go to your medical library and find it (or science library).
ONE THING ALMOST EVERYONE OVERLOOKS: The reason they came out with 2nd or 3rd generation tests. WHy did they do this Mr. Bullshit who criticized my first post? Don't know, do you? They did this to protect the blood supply you knucklehead. Dr. Jon Kaye at Organon Teknika who makes HIV-1 tests for 90% of the public health departments in this country (phone conversation, Nov 1999) stated that "a lot of good donated blood is discarded because the 2d and 3rd generation tests are too sensitive." In other words, they don't do W Blots on donated blood, they discard it!! (Now, however that is changing with NAT testing. But I won't confuse the issue). The 2d and 3rd generation tests WERE DESIGNED AND DO PERFORM THE FOLLOWING MEDICAL FEAT: THEY SHORTEN THE WINDOW PERIOD! OK, you knucklehead who posted above under the bullshit moniker.



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Not_scared
Unregistered

Re: TO: Not_Scared new
      #6911 - 07/09/00 11:01 PM

Even with a 1st generation test, I surveyed a lot of different M.D.'s (I am a microbiologist, not an M.D.) and they said it's 99% or more. ALthough most sites tell you minimally 90% but more likely 96% or better. You can tell how much this issue has consumed my life!! That's what fear can do to you! You can breathe a sigh of relief my friend. And thank God for life and a second chance like I did!
I am not an expert on PCR's but as I told someone above in another post(?), you are more likely to get a false positive than a false negative. So if you risk the false positive (a whopping 5-10% chance) and get a negative result, then it would be most improbable for you to be actually positive. The virus hits a peak level in three weeks after infection. Are you negative with a Home Access or OraSure at three months? If yes, then breath a sigh of relief then! COnclusiveness, according to the NY State Health Dept: three months with a 2d or 3rd generation test though. They would not say a 3 month with Home Access Test Kit is conclusive. (that's a first generation test)



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Not_scared
Unregistered

Re: 18 MONTHS TO FIND OUT latest ELISA tests new
      #6912 - 07/09/00 11:11 PM

"Great improvement over ten years." Wow , you must be a scientist or something. Just like a car moves you an order of magnitude faster than walking, and a plane moves you an additional order of magnitude of speed faster than a car, a second or third generation antibody test will shorten the window period significantly more than the most vastly improved first generation antibody test.
Improvements on the first generations have limits! You can only improve them so much and they reach the theoretical limits on their design.



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amoose
Unregistered

TO: Not_Scared new
      #6915 - 07/09/00 11:15 PM

I am glad to see someone so knowledgeable because I am not. I was wondering if you could tell me about the accuracy or anything else you may know about the nat test the red cross is currently evaluating. How does it effect the windo period? And why did the red cross never implement thpcr or is it the same as the nat?
Thanks for your knowledge :^)

Confused!!!!



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BDG
Unregistered

Re: TO: Not_Scared new
      #6917 - 07/09/00 11:29 PM

Very informative post Not_Scared. I got a lot of information out of it!

I have to admit, if I wasn't sure that I was tested for HIV1 and HIV2, I would probably feel a little uneasy right now. But the fact that you mentioned that M.D.'s you talked to said that the newly formulated 1st generations are around 99% accurate at 3 months should make others feel better.

I'm not sure if this will help anyone or not, but what you say about the State of N.Y. using 2nd or 3rd generation tests and then strongly recommending a 3 month window period actually corresponds quite closely with Ontario, Canada. Over here, they use a 3rd generation combined HIV1/HIV2 test at all times (in this province, only one organization - the government ministry of health labs - performs HIV tests, no private companies are licenced to do so). And in Ontario they are very adamant of the fact that the test is conclusive at 12 weeks, just like in New York.
I personally would have thought that they would be using 3rd generation assays everywhere in the world, but when you think about it, what you say makes sense. For example, with the Home Access testing kit, you only check for HIV1. I'm not sure if there would be a reason to exclude an HIV2 test if that particular assay was not a first generation assay. Unless of course it was more expensive to make the assay detect both types of virus, but somehow I doubt that it would cost much more.

Anyway, I just hope people who have had a negative test at 12 weeks don't start worrying now. After all, like you said, MDs think that even the updated first generation ELISAs catch infections 99% of the time, so people shouldn't worry!

One more thing. I'm not sure saying that the newer generation assays are used primarily in high-risk populations is 100% accurate. I'm saying that because they use them in Ontario. Now granted, Toronto is a huge city, but relatively speaking, it hasn't been affected by HIV infection as other large cities have been. But then again, it has probably been affected more than other Canadian cities, so maybe that's why they use them here. I guess what I'm trying to say is that people shouldn't assume that they were tested by a first generation test if they live in a low risk area. They should probably ask to find out!



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BDG
Unregistered

Re: TO: Not_Scared new
      #6918 - 07/09/00 11:30 PM

I think the NAT test is the same as the PCR test. Isn't it Not_Scared?



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