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  #1  
Old 03-21-2010, 01:26 PM
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Default Need for 3 month testing

Dear Dr's

I recently had a Duo and INSTI at 59 days post exposure, both were negative. (sex with prostitute, protected vaginal, unprotected oral). Prior to that I had Duo and INSTI at 40 days and an INSTI alone at 31 days, all negative. After the last tests I had come to the conclusion that I was negative. However, now doubt has been put in my mind by reading around other sites.

I gather from them that the Duo is most accurate at or around 28 days since the p24 will quickly disappear. Therefore my Duo's were basically worthless apart from as antibody tests. I know that on Medhelp Dr HHH regards 8 weeks as conclusive anyway with any generation of test, is this your view? Should I test again at three months to be sure? There are posters on that site that say that 4th gen is no more accurate than any other and people are being misled, nothing is conclusive until 3 months.

Even the latest update on BHIVA (15th March) states that testing should be with 4th gen and then confirmation at 3 months which confuses the issue further. I know they have to be cautious. Is it true that Australia and France (and a few other more advanced countries!) regard 6 weeks as OFFICIALLY conclusive with 4th generation tests?

Could you please allay my fears over the accuracy of the tests I have had, I do not want to go through the stress of testing again since I thought mine were conclusive at the time. Have you seen anyone test neg at 8 weeks with any 3rd or 4th gen test and then become positive later, I know Dr HHH on Medhelp says that he hasn't.

Many many thanks. Tom
  #2  
Old 03-21-2010, 05:46 PM
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Default Need for 3 month testing

Hi Tom

I've repeated your question beneath and added my comments in red:-

Quote:
I recently had a Duo and INSTI at 59 days post exposure, both were negative. (sex with prostitute, protected vaginal, unprotected oral). Prior to that I had Duo and INSTI at 40 days and an INSTI alone at 31 days, all negative. After the last tests I had come to the conclusion that I was negative.You are However, now doubt has been put in my mind by reading around other sites.

I gather from them that the Duo is most accurate at or around 28 days since the p24 will quickly disappearincorrect. - see the post on HIV seroconversion which details this point - basically though p24 will remain through the illness - just in varying amounts. Therefore my Duo's were basically worthless apart from as antibody testsabsolute rubbish. I know that on Medhelp Dr HHH regards 8 weeks as conclusive anyway with any generation of test, is this your viewabsolutely? Should I test again at three months to be sureno, you are wasting your time, money and emotional energy? There are posters on that site that say that 4th gen is no more accurate than any other and people are being misledyep, there are. there are also posters on lots of sites that say things like rice cures cancer, HIV does not exist etc etc - all rubbish. The 4th generation combined test will reduce the diagnostic interval to 28 days or less post exposure. , nothing is conclusive until 3 monthsthis is ultraconservative.

Even the latest update on BHIVA (15th March) states that testing should be with 4th gen and then confirmation at 3 months which confuses the issue further. I know they have to be cautious. Is it true that Australia and France (and a few other more advanced countries!) regard 6 weeks as OFFICIALLY conclusive with 4th generation testsyes?

Could you please allay my fears over the accuracy of the tests I have had, I do not want to go through the stress of testing again since I thought mine were conclusive at the time. I believe I have alreadyHave you seen anyone test neg at 8 weeks with any 3rd or 4th gen test and then become positive later, I know Dr HHH on Medhelp says that he hasn'tI/we have never seen this and we don't expect to. We do tens of thousands of tests of all descriptions and the scenario you are postulating is just not realistic. You are HIV negative. My advice would be to go with HHH and ourselves and accept you are HIV negative..
best wishes, Sean
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Old 03-22-2010, 08:45 AM
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Many many thanks for your reply, just two final questions, I forgot to add that after about 6 weeks I had booster vaccinations for Typhoid, Diptheria, Polio and Tetanus. I know they are all against bacterial infections apart from Polio, do you think these could have any bearing on the tests?

I have read the posts you mention about the issue of the p24, the only confusing thing is the graph shown on the VIDAS Duo makers website that shows the rapid drop off of p24, then the production of IgM, then IgG. Can my test be considered at least 99.89% accurate with the intervals I have had?

Regards
Tom
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Old 03-22-2010, 12:46 PM
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Hello Tom,
I am going to answer your last questions now, here as follows:

Many many thanks for your reply, just two final questions, I forgot to add that after about 6 weeks I had booster vaccinations for Typhoid, Diptheria, Polio and Tetanus. I know they are all against bacterial infections apart from Polio, do you think these could have any bearing on the tests? Not at all. These would not affect the test results at all whatsoever.

I have read the posts you mention about the issue of the p24, the only confusing thing is the graph shown on the VIDAS Duo makers website that shows the rapid drop off of p24, then the production of IgM, then IgG. Can my test be considered at least 99.89% accurate with the intervals I have had? Yes, it can, and I would consider it thus to be fully conclusive

Regards


All the best,
Jose
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  #5  
Old 03-23-2010, 12:51 PM
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Thank's Jose,

I have read on the other sticky posts that you often say that after 6 weeks an INSTI will give you 99% and a Duo will give you certainty (if you have already had previous tests). Is this based on evidence i.e. to the Duo's increased accuracy after 6 weeks? What is the accuracy of an INSTI at 8 weeks?
  #6  
Old 03-23-2010, 08:54 PM
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Default Need for 3 month testing

Hello again,

The HIV DUO will give you greater than 99.89% accuracy at 4 weeks = 28 days. the accuracy will increase as the number of days and weeks increases.

The INSTI = a 3rd generation test will give you greater than 99% accuracy at 6 weeks.

There will be an improvement in reliability and accuracy as time goes on, reaching the maximum for a biological test of 99.99 recurring %

I hope that helps.

best regards, Sean
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