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Author Topic: 4th Generation Tests  (Read 52607 times)

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Offline fred

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4th Generation Tests
« on: June 07, 2006, 01:54:14 AM »
Hi,

Can anybody explain why technically/scientifically, we cannot rely on 4th generation tests lowering the test window down to 4-6 weeks.

Forget the guidelines, I'd like the science  :)

Offline Darkfiber

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Re: 4th Generation Tests
« Reply #1 on: June 07, 2006, 02:18:56 AM »
Fred

The 4th generation assay is looking for proteins (P24) of the virus and antibodies (produced by each individuals body).

As soon as antibodies appear P24 is no longer detectable due the p24 / antibody complexing. This is true until very late stage of aids.

The twist is, that the p24 part of the assay is not very sensitive (only around 80%) which is just not high enough to exclude infection.

Eventhough the vast majority of people have detectable antibodies after 6 weeks there is a small minority who may seroconvert later (6-13 weeks)

That´s the main reason why you still need to restest after 13 weeks.

PS. In Switzerland we only use 4th generation assays (with exception of rapid tests) and we still have the 3 months windowperiod.

Hope this helps

Best regards

Darkfiber




Offline fred

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Re: 4th Generation Tests
« Reply #2 on: June 07, 2006, 02:32:41 AM »
But,

my understanding is that not all p24 assays are the same and that some can detect low levels of p24 (say 16 pg/ml) whereas as others have not such good sensitivity ( 50+ pg/ml )

Furthermore, the amount of p24 increases as infection progresses so, therefore, a test at 4 weeks and one at say 6 weeks would surely identify this increase ? (i.e. the 4 week might miss the p24, but the 6 would surely not ?)

I understand the resource ramifications, it's just the science I am interested in.

Fred

Online RapidRod

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Re: 4th Generation Tests
« Reply #3 on: June 07, 2006, 02:45:40 AM »
The P24 window period is short, 1-3 weeks of first becoming infected, as antibodies are produced, the antigens decrease to where they will not be picked up by an antigen test.

Offline Darkfiber

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Re: 4th Generation Tests
« Reply #4 on: June 07, 2006, 02:48:39 AM »
Fred

Quote
Furthermore, the amount of p24 increases as infection progresses so, therefore, a test at 4 weeks and one at say 6 weeks would surely identify this increase ? (i.e. the 4 week might miss the p24, but the 6 would surely not ?)

This is not true as such...

http://www.aegis.com/conferences/iac/2002/TuPeC4893.html

The P24 used on 4th generation assays is not  heat-dissociated and therefore has the lower sensitivity.

P24 was used for screening bloodsamples brfore technologies like NAT and PCR have been available. Those are much more sensitive.

Can I ask what was you exposure and why do you want to know?

Regards

Darkfiber


Offline fred

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Re: 4th Generation Tests
« Reply #5 on: June 07, 2006, 03:05:01 AM »
My exposure was, at worst;
10 seconds of unprotected vaginal sex with a sex worker.

RapidRod,
As the antigens decrease, the antibodies increase and most 4th Gen providers state that their markers for both p24 and Ab overlap.

Darkfiber,
"The P24 used on 4th generation assays is not  heat-dissociated and therefore has the lower sensitivity"

what is heat dissociation ?

Opinions ?

Offline Darkfiber

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Re: 4th Generation Tests
« Reply #6 on: June 07, 2006, 08:16:37 AM »
Fred

It´s a procedure used to increase sensitivity of a P24 assay. it needs to be special ordered and is not part of a usual 4th gen test.

I do not think it makes sense to go into too much details about the technology behind the tests.

It makes things only more confusing.

Fact is that there are outliers (eventhough very, very, very few) convert between week 6 and week 3 months and since the sensitivity of the p24 part is not high enough to exclude infection.

Therefore 3 months is the goal. After 3 months you now your status conclusively.

Best regards

Darkfiber




Offline fred

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Re: 4th Generation Tests
« Reply #7 on: June 07, 2006, 09:44:44 AM »
Darkfiber,

Thanks for your responses.

I however do think it is reasonable to want to understand the science behind the test.

When someone is attempting to alleviate their mental suffering waiting for 12 weeks to pass, it is kind of natural for them to look for a speedier resolution to their situation.

The assay providers, and indeed many doctors, talk about "closing the window" to 22 days for 3rd gen and 16 days with 4th gen and 12 days with NAT.

Therefore it is confusing when people voice alternative opinions that try to enforce the KISS mentality of 12 weeks.

Given that medicine offers no guarantees, any conclusiveness attached to a test result is surely a factor of a number of calculations. These being "risk" of exposure, sensitivity of test, specifity of test, clinical signs etc.

The reference you pointed me to on p24 was a stand alone p24 assay. Of the specimens used (33), 10 were negative against Elisa 3rd gen, but we don't know which 10 and whether they were picked up or not by the antigen assay.

I think the point of the exercise was to demonstrate that the p24 antigen becomes less detectable over time as antibodies are produced. As the antibodies are produced the Elisa should become positive.

Also there is no description as to the concentration of p24 in the serum that was tested or the stated minimum detection level of the assay.

I am not saying that the test is foolproof but many of the 4th Gen tests are rated as 99.8% sensitivity at 28 days.

Knowing whether this is an accurate rating or not directly feeds into the calculation, for an individual and their risk profile, as to the conclusiveness of the test result.

This would be true at 1 week, 4 weeks, 3 months, 12 months or whatever.
What is needed are reasonably definitive ratings of sensitivity at 21, 28, 35 days etc. for each Assay. This enables the patient to make an informed choice.

It almost seems like the 3 month test rule is dogma because of a lack of clear information as to why the alternatives are not "worth the money" etc.

Cheers,

Fred 

Offline Andy Velez

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Re: 4th Generation Tests
« Reply #8 on: June 07, 2006, 10:18:06 AM »
Fred, the 3 month rule is in place because not everyone is taking the same test. At 3 months any generation of any HIV test will yield an accurate result, excepting in some cases that involve IV drug use and severely impaired immune systems.

I appreciate your wanting the comfort of getting a certain answer sooner.

HIV is not an easy virus to transmit. It is significantly harder to accomplish from female to male. The incident you have described was very low risk. Given that it was a single and very brief incident the odds are overwhelmingly in your favor against transmission having occured.

Cheers,
Andy Velez

Offline fred

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Re: 4th Generation Tests
« Reply #9 on: June 07, 2006, 11:54:55 AM »
Andy,

Many thanks for your response.

Fred

Offline fred

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Re: 4th Generation Tests
« Reply #10 on: June 09, 2006, 07:19:03 AM »
I am not an expert.

My findings are this....(and remember this is not advice, just findings from reading numerous medical publications)

A couple of 4th Gen tests such as Vidas Duo Ultra and COBAS COMBI do have very good sensitivity to p24 approx 3pg/ml or so and as such make them as sensitive as any stand alone assay for p24.

I still think that having one of these tests at both 4 & 6 weeks would be an exquisitely good indication of being negative.

If p24 was undetected at 4 weeks it would most likely be picked up at 6 weeks, or if not, then antibodies would be picked up. Low undetectable levels of p24 at 6 weeks are surely due to the presence of detectable antibodies.

I am not saying that there won't be exceptions to this though, particularly with non HIV1 and some more obscure subtypes. The problem is that these exceptions do not appear to be quantified, nevertheless they do appear to be exceptions.

If anyone has any evidence that contradicts this I would welcome it.

Fred

Offline Ann

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Re: 4th Generation Tests
« Reply #11 on: June 09, 2006, 07:33:29 AM »
Fred,

There is nothing wrong with your assesment. However, considering that in your situation hiv transmission is unlikely, testing at four and six weeks is overkill and unnecessary. A negative result at either of these weeks will still have to be confirmed at the three month point.

I stand by my advice that you should wait until six weeks to test, but if you are going private to do this, well, it's your money.

Hiv is a fragile, difficult to transmit virus and more so from a woman to a man. It would be highly unlikely for you to have become infected from ten seconds of unprotected intercourse. It's unlikely, but not impossible so you do need to test, but you don't need to test quite as much as you are proposing to do.

But it is your call, and your money.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline fred

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Re: 4th Generation Tests
« Reply #12 on: June 09, 2006, 07:43:24 AM »
Ann,

Thankyou for your considered response.

Fred

Offline fred

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Re: 4th Generation Tests
« Reply #13 on: June 18, 2006, 02:19:35 AM »
I have now had a 30 day & a 53 day 4th Gen test come back negative. Todays is the 55th day and for the past 4 days I've had a sore tip of my tongue and a couple of denuded patches like geographic tongue.
Can I safely dismiss this as having nothing to do with any kind of ARS or HIV related symptom ?
No other symptoms

Offline Ann

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Re: 4th Generation Tests
« Reply #14 on: June 18, 2006, 07:26:43 AM »
Quote
Can I safely dismiss this as having nothing to do with any kind of ARS or HIV related symptom ?

Fred,

Yes, you certainly can.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline fred

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Re: 4th Generation Tests
« Reply #15 on: June 18, 2006, 01:27:09 PM »
Would it be very unusual to experience a seroconversion illness (ARS) at 8 weeks past exposure ?

Offline Ann

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Re: 4th Generation Tests
« Reply #16 on: June 18, 2006, 01:48:12 PM »
Fred,

It would be extremely unusual to experience ARS after eight weeks.

ARS, if it happens at all, normally turns up between two and four weeks after exposure and infection has taken place.

Your slight possible exposure is not very likely to lead to infection anyway. Confirm your early negative result at 12-13 weeks and put this behind you.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline fred

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Re: 4th Generation Tests
« Reply #17 on: June 18, 2006, 01:53:52 PM »
I'm trying my very best Ann.

I thank you for your patience and your compassion.  :-*

Offline fred

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Re: 4th Generation Tests
« Reply #18 on: June 19, 2006, 04:21:46 AM »
Friends,

I am in a very sorry state at the moment and I apologise for leaning on you in this way.

My mental and emotional state is beyond the scope of this forum I know. But I fear for what I
am going to lose (my wife, children, job etc.) unless I can get some inner peace of mind.

I know I am responsible for what is happening to me but I cannot seem to "get a grip"

I have struggled with Panic and Anxiety for many years, mostly related to health issues and I have
been on medication, CBT, self help books etc.

I'm not sure what else I can do to help myself.

The reason I tell you this is to try and put my situation in some sort of context and to try and
illustrate that I am not just wanting to indulged.

So far, regarding my situation;

had a 30 day 4th gen ag+ab COMBI test negative
had a 53 day 4th gen ag+ab COMBI test negative

I have had the two doctors that performed the test inform me I am HIV negative and do not need further
testing. I have had Dr.Hansfield at Medhelp.org say no further testing required (after the 30 day test)
I have had my own GP (who I explained everything to, including the testing advise that no more testing was required)
and also the Terrence Higgin Trust advise that it was time to let this go and accept my -ve status.

The only people who will not afford me that reassurance is you guys. Now I would never want to be falsely reassured by anyone
and I don't really know why I am giving your advice priority over all the other advice. ( I guess it's because, when you are fearful
you also focus on the most negative (conservative) view)

I have spent every waking moment thinking about my situtation and spent many weeks scouring the internet for information.

It was using this information that made be elect to perform my two tests 4 weeks apart (4 & 8 weeks) as this would make an
allowance for any p24 sensitivity/antibody issues and remove the possibility of a secondary window.

However, you folks still advise me to continue to get tested at 12/13 weeks.
I am not trying to put you in a difficult situation here and understand that a guideline is a guideline but it would help me
if you could explain why my logic is flawed and why the testing I have done cannot be considered conclusive.

If I told you I lived in Massachusets would you tell me my testing was conclusive ?

To compound matters I now have a sore tongue, getting hot flushes, bad breath and of course because my testing is not conclusive
I am focusing on them and thinking the worst.

Please help

Fred

Offline Matty the Damned

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Re: 4th Generation Tests
« Reply #19 on: June 19, 2006, 05:18:54 AM »
Fred,

Why are you doing this to yourself doll? If you lived in MA, we'd tell you that the health authorities there consider 6 week testing to be conclusive given the type of test they administer. Anywhere else and you've gotta go with the 12-13 week period.

That said, Ann told you that your chances of having contracted HIV from what you describe are very remote. There really is no need for all of this fuss. You should have a look at our Welcome Thread and if you have done so, read it again.

I'm not going to say you don't need to test again. The AIDSMEDS standard says 12-13 weeks and that's the advice I'm honour bound to give you. To be frank with you though, I fully expect you to collect a negative result at week 13. Really I do.

Fred, you're right about one thing, your anxieties about HIV and losing your family are beyond what we're equipped to deal with. I suspect that there are other issues bubbling away in your life. I recommend that you seek the assistance of a mental health professional. You owe yourself and your family that much.

Kind regards,

MtD

Offline Ann

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Re: 4th Generation Tests
« Reply #20 on: June 19, 2006, 05:48:57 AM »
Fred,

If I were you, I would take the advice you've been given from the doctors who administered the 4th generation tests. As we keep telling you, your test result is not going to change if you decided to test again at the end of the official window period. Your result is not going to change. Please re-read the above until it sinks in.

Your logic is not flawed, but our hands are tied where the window period is concerned. We don't like to take the chance that someone out there, who has had a serious risk, might test with what they assume to be a 4th gen test - and potentially miss an infection because they weren't actually being tested with a 4th gen test. We have to keep in mind at all times that this is a public forum and it is not just you and those of us who answer questions reading this thread.

Fred, these symptoms you are reporting sound stress related to me. Stress triggers off what is known as a fight or flight response in our bodies and what you describe are things that happen when that fight or flight response is prolonged. This response can cause you to start breathing through your mouth, because that is the quickest way to deliver oxygen to the lungs. This mouth breathing can cause all sorts of problems such as coatings on the tongue, a sore tongue, bad breath and sore throats. Mouth breathing during a night's sleep is why we wake up with bad "morning breath". Try to pay attention to your breathing. Breathe slowly and deeply through your nose and see if you don't see an improvement. A trip to the dentist wouldn't hurt either.

The hot flushes are also part of the fight or flight response. It's to do with increased heart rate and increased activation of the sweat glands - all perfectly normal during an activated fight or flight response.

There is a very good discussion of this fight or flight response available in a link I will give you in a moment. First, you need to know that where it mentions that aids is more likely to happen with prolonged stress, this only applies to someone who has already been hiv positive for years. This does not apply to you or anyone else questioning their hiv status and stress will not make you more likely to test positive. Stress is not good for those of us who are already hiv positive because it can accelerate disease progression to aids. I wish they didn't mention this because it is somewhat misleading in its briefness, but the rest of the article is excellent so I'm not going to throw the baby out with the bathwater. Click here.

One last thing Fred, please have a therapy top-up so you have some face-to-face support with these issues. It may also be beneficial for you to go back on meds for a time. Please, please see your doctor about this.

You are going to be just fine - really, you are.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline fred

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Re: 4th Generation Tests
« Reply #21 on: June 19, 2006, 07:12:35 AM »
Mtd, Ann,

Thankyou for your response, I really appreciate all of the help you folks give.

I have simply never encountered people as helpful, caring yet straightforward as you guys.

I shall endeavour to get some additional counselling.

Crazy Fred.

Offline fred

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Re: 4th Generation Tests
« Reply #22 on: June 22, 2006, 06:44:12 AM »
I am at 8 weeks 2 days after exposure.

I have Geographic Tongue and a small blister appearing on a few fingers on each hand.

I am very distressed.

Are these symtoms simply nonsense in terms of HIV ?

Please help...don't know what to do....

Online RapidRod

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Re: 4th Generation Tests
« Reply #23 on: June 22, 2006, 07:13:52 AM »
Yes it's nonsense to relate everything you find on your body to HIV.

Offline fred

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Re: 4th Generation Tests
« Reply #24 on: June 22, 2006, 07:32:56 AM »
I understand that Rod. But when you're knowledge and experience is limited and your fear is great, it is fairly common to do so.

I only meant "have you ever heard of this in relation to HIV at 8 weeks 2 days"

Not trying to offend anyone here just trying to things into some sort of context.

Thanks,

Fred

Offline Andy Velez

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Re: 4th Generation Tests
« Reply #25 on: June 22, 2006, 08:57:48 AM »
Fred, among the things you aren't listening to because your head is so busy coming up with stuff to worry about is

that neither the presence nor the absence of symptoms will ever tell you anything accurately about your HIV status.

Get it? So no matter what you "notice" is going on in or on your body it's totally irrelevant in terms of HIV.

So asking us for an opinion about your latest somatic event(s) is pointless. The issue is your anxiety and whatever is driving that, not HIV. And that's were talking with a therapist or other such professional maybe helpful to you.

Of course you should also check out troublesome symptoms with a doctor.

For what it's worth, given your test results thus far I do expect you to continue to test negative.

Andy Velez

Offline fred

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Re: 4th Generation Tests
« Reply #26 on: June 22, 2006, 09:05:03 AM »
Point taken Andy.

Just went wobbly again.

Fred

Offline fred

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Re: 4th Generation Tests
« Reply #27 on: June 26, 2006, 04:00:20 PM »
Does dry mouth, thrush, canker sores and other associated mouth symptoms typically appear during the chronic stage of HIV progression rather than during primary infection ?

My understanding is that after primary infection, and after ARS (if it occurs at all), the vast majority of people are asymptomatic. Is this true ?

This is my only stumbling block to being able to enjoy the sunshine.

I am not looking for specfics relating to me, just an indication.

Because of a history of Health Anxiety, I feel ashamed to go to my doctor ( although I've been once about Geographic Tongue) or speak to my wife about these symptoms. They are essentially dismissing me ( quite understandably in some respects).

Of course if the answer to my question is simply "maybe".... I understand.

I have booked in with a counsellor next Thursday to try and address my anxiety.

Many Thanks,

Fred.

Online RapidRod

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Re: 4th Generation Tests
« Reply #28 on: June 26, 2006, 05:30:07 PM »
We don't discuss signs or symptoms due to HIV not having specific signs or symptoms. You've been here long enough to know that we don't discuss them.

Offline fred

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Re: 4th Generation Tests
« Reply #29 on: July 05, 2006, 05:57:41 AM »
Hi,

an update

I've tried to stay away but can't seem to let go.

I now have had 3 x 4th Gen tests (COMBI COBAS ag+ab) at 30, 53 and 63 days all come back negative.

All my doctors (6 of them, 3 private, 3 NHS)  have advised that "no further testing is needed"

Yet I still sit here obsessing about the fact that my tongue is sore, that there are various small bumps, patches, blisters etc in my mouth and that my mouth is dry.

I try to tell myself that these doctors would not say "no further testing is neccessary" unless they truly believed it. Why would they take the chance ?

My inability to move on must be to do with guilt or shame or something. Many men who have done what I did, wouldn't even think twice, probably wouldn't even get tested. Should I envy them ?

When 6 independent Dr's say no further tests required, it becomes a challenge to find somewhere else that will test.

I am now at 73 days past exposure and considering more tests. I am hiding my fears from my wife because her view is that I should trust the Dr's and that, based on their advice and my tests, she has no concern about us having unprotected intercourse. My reluctance to get close to her, because of my fears, is further damaging our relationship.

I feel trapped.

Thanks for listening....

Fred.

Offline Ann

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Re: 4th Generation Tests
« Reply #30 on: July 05, 2006, 06:35:02 AM »
Fred,

We might be listening, but you are talking to the wrong people. please have a therapy top-up so you have some face-to-face support with these issues. It may also be beneficial for you to go back on meds for a time. Please, please see your doctor about this.

We cannot help you with your feelings of guilt. This is an hiv information forum, not a work through your guilt forum. Please get in touch with your therapist and schedule an appointment. ASAP. You don't have to live in constant fear of something you don't have.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Sae

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Re: 4th Generation Tests
« Reply #31 on: July 05, 2006, 09:09:50 AM »
Fred,

Its seems you are trapped in your guilt and fear and I sincerely hope you've done what the experts have advised.

Your issue is most clearly NOT HIV.  You are using HIV to scare yourself silly, to beat yourself with, to punish yourself for straying. 

You have a few choices:
1.  You can accept what you did and forgive yourself and forget it and move on.
2.  You could try to figure out what's wrong in your relationship, or within yourself to see why you did what you did and then fix things properly.
3.  You can continue to obsess and obsess yourself right out of your marriage (self fulfilling prophecy).
4.  Maybe you actually want to end your marriage, but this is the wrong way to do it.

In any case, these are choices.  Maybe your indiscretion was a cry for help, maybe it was a simple slip up which just happened.  In any case, infidelity is very often only a symptom of a deeper problem.  The fact that you have a fear and health related history and you knowingly had unprotected sex MIGHT, and I am theorizing here might mean on some level you wanted to wake yourself up and scare yourself BADLY.  Just stop confusing HIV fear with the real issue, and really start to look at the problem, not what you perceive to be the punishment.

One repeated theme throughout your posts is that is you get one LAST tidbit of information you'll be ok, but then there is always something else.  That's a clear indication that you aren't moving on.

That's my 10 cents of therapy, now please get to a professional.

Sae.
« Last Edit: July 05, 2006, 09:12:19 AM by Sae »
Meh.

Offline fred

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Re: 4th Generation Tests
« Reply #32 on: July 05, 2006, 10:46:37 AM »
Sae,

I owe you 10 cents.  :D

I think what I am looking for is permission from somebody in authority to move on.... unfortunately I also recognise that the responsibility for that, ultimately lies with me.

Thankyou for responding.

Fred.

Offline Andy Velez

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Re: 4th Generation Tests
« Reply #33 on: July 05, 2006, 11:41:01 AM »
Fred, I am wondering about how your relationship has been with your wife in general. Very often the kind of experience you're having right now serves as a distraction from other issues.

This is obviously not the place to go into it if there are other problems. You yourself have indicated maintaining intimacy with your wife is a something right now, and perhaps prior to this?

These are only ideas of mine. If they seem to fit in anyway, I suggest you see a professional and talk things out. HIV is clearly not the issue no matter what your mind maybe telling you to the contrary.

Good luck with getting things sorted out in the right setting.

Cheers, 
Andy Velez

Offline fred

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Re: 4th Generation Tests
« Reply #34 on: July 08, 2006, 04:08:09 AM »
Folks,

I am not proud of this record, and I know you may through your hands up in despair but;

I have tested negative with COMBI COBAS ag+ab (4th Gen) at
30 days
53 days
63 days
72 days

Every time the doctor has said I do not need to retest ( 3 different doctors, 2 different clinics)

My question is;

"Do I need to retest ?"

If the answer is yes, would a test at 81 days be ok ?

I go on holiday on the 82nd day and with all that I have put myself through, It would be nice to think I can start to let this obsessive behaviour go and enjoy my holiday.

If it is not OK then of course I will retest when I come back (94 days post exp.)

Other than for acedemic, past the finishing line reasons, should I be done with this now. I am 36 years of age, otherwise healthy ( apart from being a nutcase ) and my reasoning is that my tests are the most sensitive ELISA's you can get, I have had multiple tests, the Dr's say "move on", seroconversion in a healthy 36 year old male would have happened by now etc. etc.

If what I have done cannot be considered conculsive then what are my chances at this stage of continuing to pull a negative result ?

Many Thanks,

Fred.

Offline Ann

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Re: 4th Generation Tests
« Reply #35 on: July 08, 2006, 05:46:05 AM »
Fred,

You're not going to suddenly seroconvert and test positive now. Your risk was low on the scale anyway. Ten seconds of unprotected vaginal intercourse is highly unlikely to result in infection in the first place.

But you already know all this. You know that you were unlikely to become infected from ten seconds of intercourse. You know that you have repeatedly tested negative on the most sensitive tests available. You have been told by three different doctors to put this behind you. We have told you on this forum that most people who have actually been infected will test positive by six weeks - and you've tested negative at over ten weeks. I don't know what else you can be told that is going to reassure you.

Maybe now would be a good time to spend your money on getting some face-to-face support in the form of counseling before this gets much further out of hand.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline fred

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Re: 4th Generation Tests
« Reply #36 on: July 11, 2006, 05:42:11 AM »
Today is 11 weeks post exposure.

If only my tongue would stop hurting and heal I could believe my test results and move on.

I saw a couple of websites that said that Oral ulcers were an ARS symptom. My sore tongue, with patches started at 7.5 weeks post exp and are still continuing (11 weeks). This is pretty much the only symptom apart from obvious anxiety ones.

I am an intelligent guy who is very resourceful and tenacious. I thought that using my intellect and time, I could reduce my suffering. Ultimately, it probably has made the waiting time worse.

Although I have used the most sensitive ELISA's available, it only takes one person to put doubt in your mind for your confidence to be shattered.

I wish that whomever is responsible for analysing the accuracy of tests would publish the % accuracy rates at different weeks past exposure. That way you could at least have some objective measure when deciding whether to invest in a more expensive test etc. and that you could have confidence in your result.

I think what I have done, although obsessive, is pretty understandable given the fear. However the framework does not exist to support my approach. i.e. I'm on my own with it.

The fact is that the official window is 12/13 weeks and although my Dr's say that is because not all tests are equally sensitive, I can't seem to grasp it.

Unless I believed the test results and the doctor's advice, this makes all the money I have spent on tests so far (over £500) a waste of time,money and a tremendous waste of enery.

All they have enabled me to do is stagger through the window period with alternating bouts of hope and fear. the periods of hope become shorter with every test I do.

I hope that this can be a lesson for someone and that they would be well advised not to follow my path.
 
As it is, because of symptoms, I feel compelled to carry on testing.....

Of course I am more than probably in the clear but ...the damage is done and I have brought it on myself.

I just hope I can get a speedy resolution to this now, one way or the other, so that I can move forward, instead of feeling so trapped.

What a fool I feel, yet it is as if I can't help it.

Never Drink & Dunk.  ;)

Offline fred

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Re: 4th Generation Tests
« Reply #37 on: July 15, 2006, 07:11:18 AM »
Ann et al,

I have now had an additional test at 11 weeks (negative)

My mouth symptoms are what are continuing to fuel my fears.

Dry mouth, sore denuded patches towards the tip and cracking skin at the corner of my mouth.

The sore patches and dry mouth began in the 7th week and have continued now into the 11th week.
The cracking mouth has just appeared within the past few days.
I am also experiencing cold like symptoms (fatigue, tired eyes, a bit blocked up etc.)

I am not asking for comments on the specifics of the symptoms merely my logic.

My understanding is that, these cannot be ARS symptoms because of the timing and duration. Furthermore if they were some other manifestation of HIV then my tests would have shown positive by now. Is this correct ?

Is it most likely that these symptoms are indicative of stress caused by 11 weeks of obsessive fear etc. ?

Going on holiday in two days and could do with a rest from all this.

Thanks.

Offline Ann

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Re: 4th Generation Tests
« Reply #38 on: July 15, 2006, 09:02:49 AM »
Fred,

Yes, if your problems were due to hiv infection, you would have tested positive by now. Your negative test results are not going to change.

Relax and go on your holiday. You don't have hiv.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline fred

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Re: 4th Generation Tests
« Reply #39 on: July 15, 2006, 09:08:32 AM »
Thankyou, you really are an angel.

Offline fred

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Re: 4th Generation Tests
« Reply #40 on: July 27, 2006, 02:41:56 PM »
Hi,

Well I have now had my 13wk 2 dy test and it was of course negative  :)

Thankyou all for all your help and guidance over the past couple of months, It would have been much harder without you. As well as learning a lot about HIV, I have also learnt an awful lot about myself. So as well as a happy ending, there is also a silver lining to the three months of mental torment.

I can assure you that I have learn't what I need to in order that I never have to go through this experience again.

So this is goodbye, It is has been an extremely humbling experience "meeting" you all, and I wish you well.

Ann, for you a special final kiss.... :-*


Ta Ta,

Fred.

Offline fred

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Re: 4th Generation Tests
« Reply #41 on: July 31, 2006, 11:06:38 AM »
Oh dear.

Can't quite get myself to fully accept my status.

Due to fatigue, sore denuded patches on tongue and cold type symptoms. (could this all be stress related ?)

Hopefully, one last time, can you guys kick my arse and tell me that my result is absolutely once and for all conclusive and definitive ?

By coincidence, I am back in Nice, France and actually walked past the same doorway where this nocturnal activity took place 3 months ago. I walked up to the spot where it happened and guess what I saw ? a condom wrapper  :)

I even saw the exact same sex worker later in the evening, I nearly spoke to her but, I thought, "whats the point". I'm negative and she doesn't speak english....

What do you think ?

Fred.

Offline jkinatl2

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Re: 4th Generation Tests
« Reply #42 on: July 31, 2006, 11:10:17 AM »
You're done here.

You are HIV negative.

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline Ann

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Re: 4th Generation Tests
« Reply #43 on: July 31, 2006, 11:16:54 AM »
Fred,

You are without doubt hiv negative. Time to move on.

If you cannot, don't come back here, go see your doctor to find out what, if anything, is going on with your body. We cannot diagnose you over the internet. If seeing your doctor doesn't help, go to a mental health care professional and discuss your fears with him/her. We cannot offer you counseling here.

You are hiv negative and there is nothing more we can do for you here.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline fred

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Re: 4th Generation Tests
« Reply #44 on: August 02, 2006, 09:19:27 AM »
So, regardless of whatever symptoms I may be experiencing now, or in the future, no further testing is needed and that the symptoms absolutely cannot be due to HIV.

Right ?

Offline Ann

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Re: 4th Generation Tests
« Reply #45 on: August 02, 2006, 09:23:17 AM »
Fred,

That's right. Symptoms don't mean a dang thing, but the test results do. You are hiv negative regardless of symptoms. Go get them checked out, keeping in mind that you have ruled hiv out as a possible cause.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline fred

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Re: 4th Generation Tests
« Reply #46 on: August 02, 2006, 02:27:44 PM »
So absolutely negative then.

Online RapidRod

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Re: 4th Generation Tests
« Reply #47 on: August 02, 2006, 02:30:54 PM »
Yes you are negative.

Offline fred

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Re: 4th Generation Tests
« Reply #48 on: August 04, 2006, 11:12:46 AM »
Stomach gurgling, loose bowels, feeling hot and sweaty (fever), sore on tongue, tired.....at nearly 15 weeks post exposure.

Don't think I can be neg.  :'(


Online RapidRod

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Re: 4th Generation Tests
« Reply #49 on: August 04, 2006, 11:38:45 AM »
We can't be of any more help to you here on this forum. You have conclusive tested negative so it is up to you to believe what you want. You can't change your negative result.

 


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