Quick Question about p24 Antigen Test

[silversurfer2004]

I slept with a girl drunk about 4 weeks ago. First time we used a condom and next time we didn't. I didn't ejaculate

She's a bit older than I am and she parties a lot so I guess I was worried about HIV. I got sick about a week later.

She says she's HIV negative and claims she does not sleep with many guys but then I got paranoid and was like ... why did she get tested for HIV and is on the pill if she's not promiscuous?

Anyhoo, i'm just being paranoid so I got a duo test on Day 15 which came back ngeative

I'm from the US but this happened in Hong Kong - which teh world bank says is a low prevalence HIV country - 4000 cases of HIV/AIDs out of 6.5-7 million people with 25% or so being females

I was wondering

1) How reliable is this p24 test in ASIA - it was performed at the best private hospital here so I assume its same as US?

2) Are those stats about HIV prevalence reliable?

3) I'm going back to get tested Saturday at 4 weeks but my symptoms have gotten worse (cough, sneezing, aches but no fever and no rash yet)

Just a bit worried I guess

[silversurfer2004]

I just wanted to know what you think of my chancdes ... yes I know I get tested ... but alright - thanks r all the help

[LIZZIE LOU]

you're getting waaaaaaaaaaaaaay too worked up over this.

you had unprotected sex...you test...plain and simple.

you can test til the cows come out...but 3 months is "still" needed for a conclusive result.

[silversurfer2004]

Right - thats the other thing I was pointing out - given the litigious nature of the U.S - it is for liability issues obviously

But anyway back to the heart of the matter - Teak - what do you think my chances are given the negative duo test at 14 days

[Teak]

You left out the approvals that the manufactures applied for and summitted their data on. Reason for the 3 months. No doctor can change the timeline on tests summited by the manufacture to the FDA. The CDC does not have any control of the timeline only the manufacture and the FDA.

[silversurfer2004]

If I didn't explain clearly before, the average of "3 months" and previously "6 months" as discussed by UK authorities and CDC is also due to an average statistical survey of lab settings, hospitals, and local clinics

the data cited in that UK PDF of 12 weeks is specific to

"If individuals report high-risk activity within the ‘window period’ of POCTs (currently 12 weeks), either repeat testing in 12 weeks or attendance at a local healthcare HIV testing site should be encouraged."

However, if you read the section, its talking about community testing and not speciailized HIV testing (meaning, p24 testing, PCR RNA, viral load, etc)

Therefore, it obviously makes sense to err on the side of caution when prescribing a date for the general public but as doctor HHH has said on here and many other people have said - 4-6 weeks should account for the majority of people given new testing technologies etc.

I will report back with my result on Tuesday (takes 2 days to process my Duo test)

Fingers crossed but I think I'm okay? What do you think teak based on the exposure discussed (it was just a girl at my house, etc) no extraordinary circumstances (stds, warts, sores, cuts) and 1/2 time with condom 1/2 without - total less than 10 minutes

[silversurfer2004]

Okay I spoke with a clinical researcher at my university and here's what he said

Given new tests, the comfortability of 4-6 weeks in increasing. However, in order for CDC or other government agencies to claim that a certain time fram is "enough", it requires several things - one of these is universal availability of said tests.

In the U.K - 4th generation duo test is comfortable enough to be reliable post 4 weeks however the availability of such tests is NOT universal.

Same in the U.S - the Elisa test is quoted as 3 months as other methods are not readily available. Also, it has to do with politics and HMO obligations. By saying certain methods are acceptable, they open holes for healthcare companies to be liable to provde such service as well as create a new standard of care.

Therefore, to err on the side of conservatism, they say 3 months.

of course I'll get tested at 3 months but Teak, see this quote in the link you pasted

"The recommended first-line assay is one which tests for HIV antibody AND p24 antigen simultaneously. These are termed fourth generation assays, and have the advantage of reducing the time between infection and testing HIV positive to one month which is one to two weeks earlier than with sensitive third generation (antibody only detection) assays [22]. It is reasonable to expect universal provision of these assays, although they are not offered by all primary screening laboratories"


However, they do recognize that "If individuals report high-risk activity within the ‘window period’ of POCTs (currently 12 weeks), either repeat testing in 12 weeks or attendance at a local healthcare HIV testing site should be encouraged."

So while they will say 12 weeks, statistical data suggests that 4 weeks will show the majority of cases

Anyway, I guess I have my answre and will be taking a 4 week, 6-8 week and 12 week test

That's $500 ddown the drain haha

[silversurfer2004]

So are you saying that the 4 week test is not going to be useful and I should just wait or ...?

[Teak]

UK 2008 testing guidelines is still 12 weeks post exposure.
http://www.bhiva.org/files/file1031097.pdf

[silversurfer2004]

Thanks guys - wish me luck! im going to get tested Friday or Saturday (26/27 days after)

:D - i think im fine cuz this was the 1 time in my life i did something like this ... hell i've had a gf for 2 years before that and only slpt with 2 other people

I hope god doesnt punish me for this

As a side note for all who noticed - yes STD cllinincs in HK will test you free - the place i take it is $1000 HKD per test or around $150 USD ... but insurance covers it and its close to my work

if you need to be tested in HK go to the AIDs clinics - its cheaper and just as good

[depeche]

A DUO test is considered conclusive after 6 weeks by the French Health Authorities. Many clinics in UK consider it conclusive after 28 days.

USA official guidelines do say 3 months, but they don't mention DUO tests in the first place; they only make reference to the standard antibody test.  

[silversurfer2004]

right but what are my chances that these two tests are negative and then i get positive at 3 months...

i've seen u say that P24 negative at 15 days is pretty good and then 28 dys is even better?

UK standard is 28 days right? i mean i've read all these threads ... and i'm not promiscuous - just made a bad judgment call that night - we used condoms for the first time ... heh

[Teak]

3 months is when you can obtain a conclusive negative test even with a DUO test.

[silversurfer2004]

Yeah just to clarify, I had a Duo Test at top HK hospital (HK Sanitorium Hospital) and it came out negative.

Will probably go back Sunday for another Duo test (28 days)

The girl is not THAT shady, she works with my roomate and she told me she's negative but i don't know 1) how reliable that result is 2) when she got tested

Granted most of this might just be me freaking out but anyway

1) Sneeze went away
2) Cough is very very mild - mostly just scratchy throat
3) Have gotten rashes on my shoulder and chest ... but its not the pictures of maculopapular rashes i've seen - not really bumpy ... and they're small disconnected patches of a few centimeters - its getting humid so I assume its contact dermatitis or something?

Anyway, lmk what you think about the 15 day test as well as the 28 day test I'll be getting this weekend.

Thanks!

[jhguy011]

He had an antibody and P24 antigen test at 15 days.  

[Teak]

Had you been infected a negative P24 would not be reliable. P24 test has a very short window period of apx 3 weeks.

[jhguy011]

1. Reliable.  
2. Hong Kong is very developed; I would say so.
3. No comment on your symptoms

Use condoms; they're 100% effective when used correctly.