window period for ICMA test

Question

Dear Dr.

I got the ICMA from LabCorp(hiv 1/0/2) test 4 months after a risky encounter.The results were negative. I also went to an HIV specialist who did a WB test ( after I told him I tested with RAPID test and I was still concerned, because of white thing on tongue,5 Ib weight loss and other symptoms that come with acute infection )The WB test result says "no band was detected". Now my question is , Is the ICMA test for hiv 1/0/2 conclusive after 4 month of possible exposure ? and how sensitive is it compared to 3rd generation Elisa test? ( I tried to get the 3rd ELISA test, since it is considered conclsive in Canada but not available here in the US) And also if I were seroconverting when I took the WB test would there be any bands ?

Thanks for your response.

Answer

Hello,

Your negative ICMA at four months is indeed definitive and conclusive. I do not agree with the physician who ordered the Western Blot (WB). That is a test designed to be used only to confirm an initially positive ELISA or rapid test. It should not be run as an isolated diagnostic test, due to its high degree of specificity resulting in a significant number of indeterminate or false-positive results. However, luckily your WB was negative, which corroborates your negative ICMA. Yes, the ICMA is as sensitive as a third generation ELISA.

Whatever is causing your symptoms, one thing is certain: it's not HIV, OK?

Be well.

Dr. Bob