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Author Topic: testing  (Read 12895 times)

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Offline waco_jon

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testing
« on: November 13, 2008, 08:53:20 am »
what is the best test availible in the u.s that wil pick up all strains and subtypes? how is crf a/e detected? what is the window period for crf a/e?

Offline RapidRod

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Re: testing
« Reply #1 on: November 13, 2008, 09:34:05 am »
Any test is reliable that is marketed in the US. 3 months is the window period for all types, groups and subtypes.

Offline Andy Velez

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Re: testing
« Reply #2 on: November 13, 2008, 09:52:29 am »
At 3 months, any generation of an FDA-approved test will give you a reliable test result. Period. 
Andy Velez

Offline waco_jon

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Re: testing
« Reply #3 on: November 13, 2008, 04:32:39 pm »
thank you for your responses the reason i ask is i have read on several sites including this one that crf a/e has a longer window period and tests like oraquick have a high rate of giving false negatives

Offline RapidRod

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Re: testing
« Reply #4 on: November 13, 2008, 05:54:14 pm »
The tests don't look for substrains it looks for antibodies and or antigens or a combo of both.

Offline jkinatl2

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Re: testing
« Reply #5 on: November 13, 2008, 06:00:46 pm »
thank you for your responses the reason i ask is i have read on several sites including this one that crf a/e has a longer window period and tests like oraquick have a high rate of giving false negatives

If you read that here, it certainly was not in the LESSONS section. And if you are referencing the thread/poster I think you are, you must remember that this is the internet, not a science lab. People lie.
"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 waco_jon

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Re: testing
« Reply #6 on: November 19, 2008, 03:11:37 am »
i am asking because i had sex with a csw in thailand who was later confirmed to be poz i need help on where to go get tested for this strain and info about window period symptoms etc

Offline Ann

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Re: testing
« Reply #7 on: November 19, 2008, 07:26:17 am »
waco,

Unless by "sex" you mean UNPROTECTED anal or vaginal intercourse, then you weren't at risk in the first place.

Ann
Condoms are a girl's best friend

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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 waco_jon

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Re: testing
« Reply #8 on: November 19, 2008, 11:36:26 pm »
yes i was drunk and did have unprotected vaginal sex with her one time 15-20 minutes max after i returned back to the us i was having burning while urinatian for a couple weeks and it was later confirmed to be ngu which i caught from her i called her to notify her but they said she tested poz and was fired after doing research i found there are studies that say crf a/e prominent in thailand are mainly transmitted hetrosexually and the window period is longer than subtype b the main one in the us i have had all the symptoms of ars when i returned back 2 weeks later and now i have been sick for over a month with bronchitis/cold so sick the doctor prescribed me 60mg prednisone steriod a day i am convinced i am infected and need to know what test will detect this strain

Offline jkinatl2

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Re: testing
« Reply #9 on: November 19, 2008, 11:47:25 pm »
I am sorry that you read what appears to be outdated research regarding testing. Please understand that information, even scientific information, can grow obsolete over time, and is often not expunged from web sites or searches.

The current "gold standard" for determining HIV infection is, thanks to the modern testing techniques, three months.

That covers all known strains and derivatives. If an ELISA alone does not satisfy you, you may request an blood drawn ELISA plus a Western Blot (which is usually administered if an ELISA tests positive). However, I honestly think that you are going to be ok. HIV is, no matter the strain, significantly more difficult to transmit from female to male.

As for being sick now, I am sorry to hear that. A bad cold seems to be going around, all over. One of the many reasons why we do not diagnose symptoms here on AIDSMEDS.

"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 waco_jon

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Re: testing
« Reply #10 on: November 20, 2008, 12:38:21 am »
jk,

thank you for the info i have been having to worst time with this whole situation i have never been sick like this i had a rapid test done the oraquick advance hiv 1/2 and the study recently done here in Seattle where at the exact location i had my test done at claims the test is not as accurate and failed to detect 8-10 percent of true positives giving false negatives do you know exactly the accuraccy and generation of this test and if so does it pick up crf a/e?

Offline jkinatl2

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Re: testing
« Reply #11 on: November 20, 2008, 12:45:45 am »
Sorry, I must ask you to provide documentation to show this "false negative" situation. All I know regarding oral tests are the number of false positives they give, often leading to unwarranted worry until followup testing concludes that no HIV infection is present.

While I would love to once again delve into the scientific world to peruse the depths of HIv testing quantification, I must ask you for your sources and your assertive proof before I roll up my sleeves and do the same. I would not want to repeat research that you have painstakingly embarked upon.

"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 waco_jon

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Re: testing
« Reply #12 on: November 20, 2008, 12:58:59 am »
here it is

Henry J. Kaiser Family Foundation U.S. News Seattle Department Finds OraSure HIV Test to Be Less Accurate Than Label Claims

September 5, 2008

A report by Public Health -- Seattle and King County in Washington state has found that testing with OraSure Technologies' OraQuick test provides less accurate results than the label claims, Bloomberg reports. The OraQuick test is the only rapid test licensed to screen both oral fluids and blood for HIV, according to Bloomberg. Bob Wood, director of the HIV/AIDS control program at the Seattle-based department, said that in 5,460 tests, OraQuick failed to detect at least 8% of 133 people found to be HIV-positive with a comparable diagnostic. This compared with the 0.7% rate given on the test's label.

Elliot Cowan, chief of FDA's Center for Biologics Evaluation and Research Office of Blood Research and Review, said the agency has asked OraSure to investigate the issue. "We're keeping an ear to the phone and making sure they're doing what they're supposed to do," Cowan said, adding, "The ultimate goal is that the package insert appropriately represents the performance of the test." According to Bloomberg, CDC, which recommends testing with blood over oral fluids, also has contacted Seattle officials. Nonetheless, the agency sent a letter to physicians on Aug. 20, voicing support for oral fluid HIV testing and stating that the test has performed well "overall" and is important for increasing the number of people tested for HIV. Richard Wolitski, acting director of CDC's Division of HIV/AIDS Prevention, said, "At this time, based on all the available data, we're not changing our recommendations regarding oral fluid rapid testing."

OraSure Chief Science Officer Stephen Lee said the company tracks the performance of its test and routinely investigates complaints. Lee also said OraSure keeps FDA informed of all the product information it gathers. "All the data that we've accumulated indicates the product continues to perform according to its FDA-approved claims," Lee said.

Wood said that the department has sent its data to physicians and clinics in the area along with a recommendation to test blood rather than oral fluids when possible. "Our recommendation is that people shouldn't use rapid oral tests if they can avoid it, but there are some situations where it can't be avoided and it's better than nothing," Wood said.

According to Wood, Seattle in 2003 began back-up testing of samples screened with OraQuick. A laboratory test, called EIA, showed that OraQuick missed 10 out of 133 patients with HIV antibodies in their blood. Lee said that studies have shown rapid tests to be less sensitive than lab antibody tests, adding that other rapid tests have produced similar results. Seattle officials also tested the samples with a more accurate test that looks for HIV's genetic material. The test can detect more HIV cases because the virus appears in blood before antibodies, according to Bloomberg. When compared with the RNA test, OraQuick missed 17% of cases, according to Wood, who added that the results might be published in a journal in the future (Lauerman, Bloomberg, 9/3).



Offline jkinatl2

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Re: testing
« Reply #13 on: November 20, 2008, 02:35:31 am »

Reading the full text, it seems to show that the false negatives were based, as is most HIV prevention science, on patient report. Patient report is only "hard" science when the experiment is controlled. In the case of HIV transmission, in the absence of defying ethical standards and incarcerating patients and removing them from human contact, the science is dependent upon patient reliability.

I offer you this:

http://www.jstor.org/pss/3763123

I read what you posted, and give you this:

Quote
With oral mucosal transudate and serum samples from 101 human immunodeficiency virus type 1 (HIV-1)-infected subjects and 100 HIV-1-negative volunteers, the OraQuick HIV-1 test demonstrated 100% specificity and 96% sensitivity. Four false-negative subjects, who were characterized by early initiation of effective antiretroviral therapy, demonstrated waning serum anti-gp41 titers and Western blot band intensities.


Source:
http://jcm.asm.org/cgi/content/full/41/5/2153

Also look into this:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1694615

Granted, the study is pretty old, but it has been my experience that behavioral studies tend to be far longer lasting, efficacy-wise, than chemical or epidemiology based studies.

Short answer, people lie. Especially to authority figures. Especially to people in lab coats. And especially when the idea of punishment or withholding of reward is concerned. For some people, that punishment may be discontinuation in a clinical trial. For others, the reward is attention paid in an online support forum. People have quirks.

Thing is, the concern I feel over the Oraquick test is for false positives, not negatives. Which, given the way the test is designed, makes sense. Rather make something hypersensitive then not.

All my research leads me to seriously question the Oraquick, but for the opposite reason you mention, and to be fair, I have yet to see substantiation for the article you mention in anything that does not involved the patient report. Sadly, assuredly, people lie.

People get tested way too soon, yet claim otherwise. People have other high risk activities, yet assure researchers they have not. And this information, once placed into a journal, becomes assumed to be fact. Which is sad to me, because it introduces a very soft science into a hard one.

Fact is, you had a risk. And if you have trouble with the Oraquick test, then by all means, request a blood draw. And a Western Blot, if you want. It is your right to do so.

however, and this is as close as judgment as you are going to get from me. You are obviously very concerned about HIV infection. Concerned enough that you have posted here multiple times, over multiple situations. Yet this last time, you just got drunk and barebacked.

Whats up with that?

All the science and the epidemiology and the mish-mash of sociology,psychology and hard data notwithstanding, if you use a condom for penetrative sex, then substrains and subtypes and antiquainted/unsubstantiated data will do you no good in the long run. You are simply playing russian roulette with your life.

True, HIV of ANY strain is substantially more difficult to transmit from female to male. So odds are ALWAYS going to be in your favor. However, other STDS, as you discovered, are far less... forgiving is not the best term, but it's the only one I could think of. Its totally your call if you wanna get drunk and get your groove on with some sex workers in Thailand. But given your history of HIV paranoia and worry, I have to ask you if you are not doing all this for a reason.

And only you know that reason. And sadly, we here at Aidsmeds are not qualified at all to figure that out.

I know it sounds cliche, but seriously, I hope you find a professional to talk to about your fears and your behavior. They seem to be totally at odds with one another, and bring you here again and again.

Me, personally, I am a bigger fan of the blood drawn ELISA/WS combo packet. But for your run of the mill person in the US, the Oraquick seems to be totally appropriate. Overboard, even, in it's tendency for false positives.

Problems always, and WILL always arise when researchers try to mash patient report into hard data. When I see the clinical, petri/DNA/RNA/Simian data that supports the idea that Oraquick gives a significant false negative, I will certainly revise my estimates of that test and actively persue a revision in the LESSONS section to reflect that.


"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 RapidRod

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Re: testing
« Reply #14 on: November 20, 2008, 03:29:19 am »
That test study was flawed because the testing guidelines were not followed. Those that received a false negative took the test to early. A conclusive negative test result is 3 months post exposure and is stated in Oralsure testing brochures.

Offline waco_jon

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Re: testing
« Reply #15 on: November 20, 2008, 03:32:57 am »
rapid rod,

not to question your intelligence but where does it state they took the tests early?

Offline waco_jon

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Re: testing
« Reply #16 on: November 20, 2008, 03:37:23 am »
jk,

thank you for the response i appreciate the info but its states that the tests failed to detect 133 positive tests. dont you think that out of all the 133 people that none of them were honest about there expsoure dates?

Offline RapidRod

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Re: testing
« Reply #17 on: November 20, 2008, 03:42:08 am »
Dr. HHH, talked about it on MedHelp which he is on the staff at King County Department of Health.

Offline waco_jon

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Re: testing
« Reply #18 on: November 20, 2008, 04:48:26 am »
rapid can you give me the link where i can find it?

Offline Ann

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Re: testing
« Reply #19 on: November 20, 2008, 07:06:38 am »
waco,

The bottom line here is that if you don't trust the rapid test you had done, go get a blood based test. It really is as simple as that. You can read stuff on the internet until the cows come home, but I sense only another test will satisfy you.

Go get a blood test (there is a rapid blood test, it's only the oral swab with a question mark hanging over it) and collect what I fully expect to be another negative result.

And by the way, the symptoms that sometimes accompany hiv seroconversion don't actually have anything to do directly with the virus itself. The symptoms are the physical evidence of the process the body goes through while creating antibodies. So, if your symptoms do in fact have anything to do with hiv, you will test positive by now, no matter where in the world you got infected.

So go test with a non-oral swab test and put your mind at rest once and for all.

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 waco_jon

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Re: testing
« Reply #20 on: November 20, 2008, 04:30:49 pm »
thanks Ann,

so in my situation what test is the best one i can go get money is no object to detect crf a/e and how long should i wait 3 months 6?

Offline RapidRod

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Re: testing
« Reply #21 on: November 20, 2008, 04:33:13 pm »
Your question has been answered in previous replies go back and reread the replies you have been given.

Offline Ann

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Re: testing
« Reply #22 on: November 20, 2008, 07:39:29 pm »
waco,

Whatever. It doesn't matter. Just go to a testing center and ask for any type of hiv antibody test EXCEPT for an oral swab. I'm only saying this because you obviously don't trust the swab because of recent media reports. All you're doing is confirming your negative result.

The window period is three months.

And like Rodney says, re-read your thread. Your questions have been answered several times now.

Ann
« Last Edit: November 20, 2008, 07:41:31 pm by 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 waco_jon

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Re: testing
« Reply #23 on: November 21, 2008, 02:48:56 am »
ok i have no problem with that i am on 60mg of prednisone rote now and would like to know after i am done taking it next week how long i should wait to get the most accurate results

Offline RapidRod

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Re: testing
« Reply #24 on: November 21, 2008, 05:38:26 am »
Like was told to you before, go back and reread your replies that you've already received. The answers are not going to change.

Offline Ann

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Re: testing
« Reply #25 on: November 21, 2008, 07:21:19 am »
waco,

Prednisone does NOT affect the window period. As long as it has been three months or more since this incident, you can test for a conclusive result.

I deleted the post you left in someone eles's thread. If you'd bothered to read the Welcome Thread like you're supposed to, you will have read the folllowing posting guideline:

Quote
Only those Moderators and members who are authorized to answer questions in the Am I Infected? forum are permitted do so. Unauthorized responses may be deleted without permission of the poster. Repeatedly posting replies of this nature may result in a Time Out or permanent ban, at the discretion of the Moderator Team.

Please consider yourself warned.

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 waco_jon

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Re: testing
« Reply #26 on: November 26, 2008, 04:32:50 am »
thank you and sorry i didnt mean to post in anyone elses thread i just seen someone in my situation and wanted to be of help anyways what is the window period for subtype a/e? i know the studys done in the us are for subtype b which is why i ask

Offline Ann

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Re: testing
« Reply #27 on: November 26, 2008, 06:04:37 am »
waco,

Today's tests will pick up antibodies for any type of hiv by the end of the three month window period. Most people who have actually been infected will seroconvert and test positive by six WEEKS, regardless of type.

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 waco_jon

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Re: testing
« Reply #28 on: November 26, 2008, 07:03:37 am »
thanks ann how come it seems so many test positive after 3 months?

Offline Ann

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Re: testing
« Reply #29 on: November 26, 2008, 07:39:59 am »
waco,

It's very RARE for a person to test positive after three months. If you're forming that opinion on what you've read in other forums here, you need to remember that people often don't mention (and sometimes don't remember due to drugs/alcohol) the risky behaviour they've engaged in between tests.

You've never said where you are at in your window period. If you're at or over three months, go test and get it over with already. Posting on an internet forum will never tell you your hiv status. Only testing will. If you keep posting here without bothering to test, you'll be given a time out to encourage you to go get it done.

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 waco_jon

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Re: testing
« Reply #30 on: November 26, 2008, 11:38:16 am »
ive tested 3 times 8 weel elisa 10 week oraquick 14 week oraquick im just scared of false neg

Offline RapidRod

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Re: testing
« Reply #31 on: November 26, 2008, 12:48:15 pm »
This forum cannot be of any further help to you. You have a conclusive negative test result. Seek professional counseling as to why you can't accept your results.

Offline Andy Velez

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Re: testing
« Reply #32 on: November 26, 2008, 02:18:12 pm »
The facts are that you have reliably tested negative for HIV. You ARE HIV negative. Period. End of story.

Your feelings about it are another matter. As Rod suggested, maybe you need to get some professional help to deal with why you are holding on to your fears when there is no basis for it in HIV science.

We can't help with that in this setting. And if you keep coming back with same issue you're going to end up getting a time out.

Andy Velez

 


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