Dear doctor,
(excuse my English. I´m from Czech Republic and I learn English a brief period)
My problem is :
I had sexual commerce with african prostitute (immigrant) one year ago. Unfortunately came to break condom and to mutual mucosas contact. I had fever and hard sore throat during the second and third week after this incident. I was tested with hiv 1,2 dual test Ag/Ab negativ after 59 days. The next tests after 105 days and after 7months were again negativ. (The test used in Czech Republic are approved in EU) But I´m afraid, that this woman could be infected with some rare or for the present (new) unknown type (strain, subtype) of hiv, that is not by antibodies test detectable. By the people from african countries this possibility exists. Maybe is the probability low, but i want to make certain. We have regrettably no experts in this problems in Czech Republic. No one deals with issue here.
So i have following questions, if you can help me :
1)Does the test antigen p24 detect for a certainty a new unknown or rare subtype of hiv 1 in the 59 day after exposition ?
2) What test or biological analysis can anything appropriate detect ? (I mean new subtype (strain) )
What can you recomand to me ?
I do understand why you are worried but I do not believe that you have HIV.
I believe you are HIV negative.
You have asked:-
1)Does the test antigen p24 detect for a certainty a new unknown or rare subtype of hiv 1 in the 59 day after exposition ? p24 is produced by infection with HIV 1 - currently the test will identify all the known strains etc - if we were to have a new strain then I suppose that there might be a possibility of missing the diagnosis using currently established tests - however, to date, we are not as far as we are aware in this situation and the combined HIV test you have had seems to reliably identify HIV 1 and 2
2) What test or biological analysis can anything appropriate detect ? (I mean new subtype (strain) )
What can you recomand to me ?Well look, if we do have a new strain that current tests are unable to detect then by definition - on your theory - we are not going to be able to detect it. As I say, I do not believe that is the case - I believe that we are able with current testing methodologies to detect all known straisn and subtypes. If you remain concerned the I would suggest you have an HIV 1 and 2 RNA PCR test to determine whether there is any virus detected in your blood. These are not antibody or antigen tests but tests which look directly for viral genetic material.
I read on website (medhelp.org) in another post recently that Dr Hook said:
Concerns about "rae subtypes" are an internet fueled myth.Current tests detect the antigens which are common to all strains of HIV when used in currently configured serological tests. Similarly, the p24 antigen is an antigen widely shared by HIV strains and subtypes.
Do you agree ? so if i was to have a rare subtype then it would be detected in any current dual tests ?
Well look, if we do have a new strain that current tests are unable to detect then by definition - on your theory - we are not going to be able to detect it. As I say, I do not believe that is the case - I believe that we are able with current testing methodologies to detect all known straisn and subtypes. If you remain concerned the I would suggest you have an HIV 1 and 2 RNA PCR test to determine whether there is any virus detected in your blood. These are not antibody or antigen tests but tests which look directly for viral genetic material.
new subtype
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