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Is HIV 4th Generation Test Done 3 Years Post Exposure Conclusive?
Question: To be answerd by Dr.S XXXXXXX
sir i am XXXXXXX and my high risk hiv exposure was in november 2013 and i got tested with a 4 rth generation ag/ab test in March 2017 (approx 3 year after high risk exposure)and the result was non-reactive.In november 2015 (2 years after my high risk exposure) i have taken CORTICOSTEROIDS and STEROIDS for allergies and eye infection for quiet sometime and the dosage for nasal decongection is 55mcg per spray(triamcinolone acetonide which is a glucocorticoid) twice a day.i have read that corticosteroids and steroids are considered to be immunesuppressive drugs and therefore can delay the window period from 3 to 6 months post exposure.In this case my questions to you sir are
1.is my 4 rth gen ag/ab test (RAPID TEST) by alere conclusive?
2.will this single test suffice or do i have to undergo further testing?do i have to takeup a viral load test or a western blot? this is my MAIN CONCERN
3.i have been reading in the interner about ELISA tests.what are HIV ELISA tests can you please name them for me? is my 4 rth gen ag/ab rapid test an elisa test?
4.in your expert opinion,will my usage of corticosteroids and steroids use,affect my test results?
5.i heard only a positive/reactive test result need to be confirmed by further testing and not a non-reactive result.is this the case with me or do i need any further testing.
6.do i need any STD tests.please suggest all the tests in regards to std.i have no physical symptoms so far.
sir i am XXXXXXX and my high risk hiv exposure was in november 2013 and i got tested with a 4 rth generation ag/ab test in March 2017 (approx 3 year after high risk exposure)and the result was non-reactive.In november 2015 (2 years after my high risk exposure) i have taken CORTICOSTEROIDS and STEROIDS for allergies and eye infection for quiet sometime and the dosage for nasal decongection is 55mcg per spray(triamcinolone acetonide which is a glucocorticoid) twice a day.i have read that corticosteroids and steroids are considered to be immunesuppressive drugs and therefore can delay the window period from 3 to 6 months post exposure.In this case my questions to you sir are
1.is my 4 rth gen ag/ab test (RAPID TEST) by alere conclusive?
2.will this single test suffice or do i have to undergo further testing?do i have to takeup a viral load test or a western blot? this is my MAIN CONCERN
3.i have been reading in the interner about ELISA tests.what are HIV ELISA tests can you please name them for me? is my 4 rth gen ag/ab rapid test an elisa test?
4.in your expert opinion,will my usage of corticosteroids and steroids use,affect my test results?
5.i heard only a positive/reactive test result need to be confirmed by further testing and not a non-reactive result.is this the case with me or do i need any further testing.
6.do i need any STD tests.please suggest all the tests in regards to std.i have no physical symptoms so far.
Brief Answer:
No need for further HIV test, Recommended STD panel to rule out STD.
Detailed Answer:
Hi,
Welcome back to HCM.
Thanks once again for posting your query.
1. You are correct. Steroids are immunosuppressive drugs and can delay the antibody formation inside the body against any infection including HIV. Bu it is definitely not more than 6 months after the possible entry of the organisms and never beyond that. You had taken your steroid drugs only 2 years after the exposure. So it could not affect your test reports anyway. So your test reports are highly reliable.
2. I understood from your previous sessions that you had undergone HIV tests 3 times in 2015, 2016 and 2017 . So you need no further testing for HIV.
3. About the exact test techniques and the principle it is better to clarify with a microbiologist or a lab specialist.
4. Corticosteroids taken by you during 2015 would not have any effect over your test reports.
5. No further test is necessary for you.
6. It is better to rule out STDs also with appropriate tests. STD pane test are vailable.
Tests for syphilis, Hepatitis Band C, HSV infection, Urine exams for the presence of urethritis, Test for Chlamydia are essential for completion sake.
Dr S.Murugan
No need for further HIV test, Recommended STD panel to rule out STD.
Detailed Answer:
Hi,
Welcome back to HCM.
Thanks once again for posting your query.
1. You are correct. Steroids are immunosuppressive drugs and can delay the antibody formation inside the body against any infection including HIV. Bu it is definitely not more than 6 months after the possible entry of the organisms and never beyond that. You had taken your steroid drugs only 2 years after the exposure. So it could not affect your test reports anyway. So your test reports are highly reliable.
2. I understood from your previous sessions that you had undergone HIV tests 3 times in 2015, 2016 and 2017 . So you need no further testing for HIV.
3. About the exact test techniques and the principle it is better to clarify with a microbiologist or a lab specialist.
4. Corticosteroids taken by you during 2015 would not have any effect over your test reports.
5. No further test is necessary for you.
6. It is better to rule out STDs also with appropriate tests. STD pane test are vailable.
Tests for syphilis, Hepatitis Band C, HSV infection, Urine exams for the presence of urethritis, Test for Chlamydia are essential for completion sake.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Raju A.T
Can I continue taking nasacort(glucocorticoids) nasal spray for my pollen allergy as you say I need no further testing. If I want to test in future when should I consider testing if I am on glucocorticoid drugs now ?
Brief Answer:
You don't need any more tests for HIV.
Detailed Answer:
Hi,
Welcome back.
You are already free from HIV. Unless you have a fresh exposure, you don't need any more tests for HIV.
Nasal spray would not influence on antibody formation as the blood concentration of steroid is very low and has no effect on seroconversion. Seroconversion would not occur 6 months after the exposure.
Dr S Murugan
You don't need any more tests for HIV.
Detailed Answer:
Hi,
Welcome back.
You are already free from HIV. Unless you have a fresh exposure, you don't need any more tests for HIV.
Nasal spray would not influence on antibody formation as the blood concentration of steroid is very low and has no effect on seroconversion. Seroconversion would not occur 6 months after the exposure.
Dr S Murugan
Above answer was peer-reviewed by :
Dr. Kampana
No fresh exposures sir but the more I think about it the more doubts I am having.sir clarify this for me,
1.any non- reactive result ( even if it is just one test result) after 6 months of possible high risk exposure is considered conclusive irrespective of what conditions and what medications( including immunosuppressive drugs) the individual is on. Am I right in saying so. Please confirm.
2.sir when you say " 2 different tests make the result 100% conclusive" what do you mean by "different tests"- is it 2 rapid tests from different manufacturers or do u mean a rapid test and a confirmatory test like western blot / viral load ? Please clarify this as well sir for my peace of mind.
1.any non- reactive result ( even if it is just one test result) after 6 months of possible high risk exposure is considered conclusive irrespective of what conditions and what medications( including immunosuppressive drugs) the individual is on. Am I right in saying so. Please confirm.
2.sir when you say " 2 different tests make the result 100% conclusive" what do you mean by "different tests"- is it 2 rapid tests from different manufacturers or do u mean a rapid test and a confirmatory test like western blot / viral load ? Please clarify this as well sir for my peace of mind.
Brief Answer:
You are free from HIV infection.
Detailed Answer:
Hi,
Welcome back.
1. Non reactive HIV test report 6 months after the high risk exposure is conclusive that the individual is free from HIV.
2. All the HIV tests available in the market are highly reliable up to the extent of 97% and more. Especially the 4th generation test is reliable up to 99%. No test is considered 100% fool proof. At the same time as per national AIDS control organization of XXXXXXX nonreactive report with two different HIV test (Rapid and ELISA or two different Rapid tests from different manufacturers, or a rapid test with 4th generation test or Western blot test) are considered as 100% reliable.
Forget about the incident and relax.
Dr S.Murugan
You are free from HIV infection.
Detailed Answer:
Hi,
Welcome back.
1. Non reactive HIV test report 6 months after the high risk exposure is conclusive that the individual is free from HIV.
2. All the HIV tests available in the market are highly reliable up to the extent of 97% and more. Especially the 4th generation test is reliable up to 99%. No test is considered 100% fool proof. At the same time as per national AIDS control organization of XXXXXXX nonreactive report with two different HIV test (Rapid and ELISA or two different Rapid tests from different manufacturers, or a rapid test with 4th generation test or Western blot test) are considered as 100% reliable.
Forget about the incident and relax.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Prasad
sir, the window period for hiv is considered 3-6 months depending on the individual(6 months if on immunosupressive drugs) for conclusive results-in this case - when a patient on immunosuppresive drugs comes in at after 3 months of high risk exposure you would test with 4 rth gen(AND THE RESULT BEING NON-REACTIVE) and ask the patient to get tested again after 6 months for more conclusive results.correct? my question is CAN THIS SECOND TEST AT 6 MONTHS ALSO BE WITH THE SAME 4 RTH GEN TEST?
2.IF TESTING BOTH TIMES(3 months and at 6 months) IS WITH THE SAME 4 RTH GEN TEST FROM THE SAME MANUFACTURER CAN THOSE RESULTS BE CONSIDERED CONCLUSIVE? YES/NO
2.IF TESTING BOTH TIMES(3 months and at 6 months) IS WITH THE SAME 4 RTH GEN TEST FROM THE SAME MANUFACTURER CAN THOSE RESULTS BE CONSIDERED CONCLUSIVE? YES/NO
Brief Answer:
We can repeat 4th generation HIV test once again after 6 months.
Detailed Answer:
Hi,
Welcome back.
1. Yes, If the individual was on Immunosuppressive drugs during the first three months period following exposure, I would recommend to go for another test 6 months after the risky contact preferably with a 4th generation test.
2. Nothing wrong to have the 4th generation tests once again after the end of 6 months, even if the first test was negative with the same 4th generation test at the end of 12 weeks, as it has two parts (both antigen and antibody part of tests) and I will consider as conclusive.
Dr S.Murugan
We can repeat 4th generation HIV test once again after 6 months.
Detailed Answer:
Hi,
Welcome back.
1. Yes, If the individual was on Immunosuppressive drugs during the first three months period following exposure, I would recommend to go for another test 6 months after the risky contact preferably with a 4th generation test.
2. Nothing wrong to have the 4th generation tests once again after the end of 6 months, even if the first test was negative with the same 4th generation test at the end of 12 weeks, as it has two parts (both antigen and antibody part of tests) and I will consider as conclusive.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
WITHOUT ANY FURTHER TESTING?
i mean to ask if testing both times (3 months and 6 months) is with the same 4rth gen test from the same manufacturer can those results be considered conclusive WITHOUT ANY FURTHER TESTING? YES/NO
2.if the patients is not on immunosuppresive drugs but on different medications and comes in after 3 months of high risk exposure,testing with 4 rth gen ag/ab test is appropriate and if non-reactive CAN IT BE CONSIDERED CONCLUSIVE WITHOUT ANY FURTHER TESTING? YES/NO
3.can EYE DROPS(for eye infection and dry eyes) INTERFERE WITH HIV TESTS BY DELAYING THE ANTIBODY FORMATION AND PRODUCING FALSE NEGATIVE RESULTS?CAN THEY AFFECT THE RESULTS IN ANYWAY?
i mean to ask if testing both times (3 months and 6 months) is with the same 4rth gen test from the same manufacturer can those results be considered conclusive WITHOUT ANY FURTHER TESTING? YES/NO
2.if the patients is not on immunosuppresive drugs but on different medications and comes in after 3 months of high risk exposure,testing with 4 rth gen ag/ab test is appropriate and if non-reactive CAN IT BE CONSIDERED CONCLUSIVE WITHOUT ANY FURTHER TESTING? YES/NO
3.can EYE DROPS(for eye infection and dry eyes) INTERFERE WITH HIV TESTS BY DELAYING THE ANTIBODY FORMATION AND PRODUCING FALSE NEGATIVE RESULTS?CAN THEY AFFECT THE RESULTS IN ANYWAY?
Brief Answer:
Eye drops won't influence the HIV test results
Detailed Answer:
Hi,
Welcome back.
1. Yes, it is enough. No further test is necessary
2. No. If the patient was on immunosuppressive drugs after the exposure, the 4th generation HIV test can not be taken as absolute one, (even though the antigen part of the test is reliable), another test at the end of 6 months following the exposure can be taken as conclusive.
3. Eye drops won't have influence on the seroconversion.
Dr S Murugan
Eye drops won't influence the HIV test results
Detailed Answer:
Hi,
Welcome back.
1. Yes, it is enough. No further test is necessary
2. No. If the patient was on immunosuppressive drugs after the exposure, the 4th generation HIV test can not be taken as absolute one, (even though the antigen part of the test is reliable), another test at the end of 6 months following the exposure can be taken as conclusive.
3. Eye drops won't have influence on the seroconversion.
Dr S Murugan
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
2.if the patients is NOT on immunosuppresive drugs but on different medications and comes in after 3 months of high risk exposure,testing with 4 rth gen ag/ab test is appropriate and if non-reactive CAN IT BE CONSIDERED CONCLUSIVE WITHOUT ANY FURTHER TESTING? YES/NO
Brief Answer:
No 2 person's body will behave same way to any offending substance/organism
Detailed Answer:
Hi,
Welcome back.
I will say YES.
At the same time, you should understand that no single test can be considered as 100% conclusive.
Whereas the 4th generation test is said to be reliable up to more than 99% even by 6 weeks after the exposure. So a 4th generation test can be considered conclusive 3 months after the high-risk contact if the individual was not having any history of intake of immunosuppressive drugs as far as HIV is concerned.
One more thing XXXX, I'd like to bring it your notice. Medicine is not just like mathematics to get a constant answer. Nobody can predict as YES/NO. We can predict the probabilities. Every individual's body behaves differently at the various situation and react with variations.
So please try to understand the same.
Dr S.Murugan
No 2 person's body will behave same way to any offending substance/organism
Detailed Answer:
Hi,
Welcome back.
I will say YES.
At the same time, you should understand that no single test can be considered as 100% conclusive.
Whereas the 4th generation test is said to be reliable up to more than 99% even by 6 weeks after the exposure. So a 4th generation test can be considered conclusive 3 months after the high-risk contact if the individual was not having any history of intake of immunosuppressive drugs as far as HIV is concerned.
One more thing XXXX, I'd like to bring it your notice. Medicine is not just like mathematics to get a constant answer. Nobody can predict as YES/NO. We can predict the probabilities. Every individual's body behaves differently at the various situation and react with variations.
So please try to understand the same.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Sir what is the standard protocol you would or doctors would follow when a patient comes in for hiv testing ?
2.but in my case, 2 different rapid tests( 3 Rd gen ab test and 4 rth gen ag/ab tests) NON-REACTIVE multiple times(5 times) at different time frames (1.5,2.7 and 3.3 years) after high risk exposure can be considered conclusive 100% with out any more further testing ? THIS IS MY MAIN CONCERN sir
2.but in my case, 2 different rapid tests( 3 Rd gen ab test and 4 rth gen ag/ab tests) NON-REACTIVE multiple times(5 times) at different time frames (1.5,2.7 and 3.3 years) after high risk exposure can be considered conclusive 100% with out any more further testing ? THIS IS MY MAIN CONCERN sir
Brief Answer:
You are free from HIV infection.
Detailed Answer:
Hi,
Welcome back.
I already assured you that you are free from HIV many times.
Normal protocol for HIV testing is as per national AIDS Control organization of XXXXXXX a negative report 3 months after the exposure can rule out HIV. No need for further test, provided if you follow safe sex.
If one test becomes positive, then it has to be confirmed with one or two more tests to confirm the result before declare the individual to be positive for HIV.
Dr S Murugan
You are free from HIV infection.
Detailed Answer:
Hi,
Welcome back.
I already assured you that you are free from HIV many times.
Normal protocol for HIV testing is as per national AIDS Control organization of XXXXXXX a negative report 3 months after the exposure can rule out HIV. No need for further test, provided if you follow safe sex.
If one test becomes positive, then it has to be confirmed with one or two more tests to confirm the result before declare the individual to be positive for HIV.
Dr S Murugan
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Above answer was peer-reviewed by :
Dr. Raju A.T
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