[Question #10785] RV217 study acute hiv

19 months ago

Hello,

Can you give your insights on the RV217 study? Are the methods they used to test for early hiv as sensitive as a commercial hiv rna test or more sensitive? Does this study support a 6 week conclusive test using 4th gen test? Were there any outliers in their findings that fell outside of the window periods that you support? I'm still looking through reports online because I am still having stomach issues and diearea. I read hiv dust mainly takes over the gut is this true?

Based on reading through this study and your responses to my previous thread of questions gives me reason and logic based thinking that my symptoms aren't due to ARS but honestly can't help but think about it everytime my stomach hurts which is frequently after i had my fever 4 weeks back.

I've read through alot of the posts and didn't see any post about the rv217 study so I'd like to gauge your thoughts on it.

H. Hunter Handsfield, MD

19 months ago

Welcome back, but I'm sorry you remain so concerned following the rather detailed discussion we just had, and the conclusive evidence, discussed in detail, that you do not have HIV.

I'm sorry that I am not familiar with the details of the study you cite. Looking at the citation, I recall seeing it when it was published several years ago. It's high quality research by superb invesitagors, but it's not a particularly prominent study that most experts would recognize. (I was unaware of the RV217 study designation.) On reviewing the abstract at this time, I see nothing in it that has any bearing on your risk for HIV or the timing or reliability of your negative HIV tests. Those results prove you do not have either HIV1 or HIV2. There's nothing I can add.

I would strongly suggest you stop delving into the weeds to the point of looking up HIV related research papers. Like many anxious persons, it is apparent you are being drawn to information that supports your fears and missing the reassuring information that is out there. It isn't worth it.

Sorry I can't be more helpful. Happy new year.

HHH, MD

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19 months ago

Hi Dr. Handsfield

I'm sorry to be back asking another question but my anxiety is really eating at me. I know your advice was to not dig through the weeds but unfortunately i did just that. Because I can barely think straight canb to help answer some of these questions i would really appreciate it.

I saw in the labcorp test form the biotin can cause false negatives. I have been taking 700mcg of biotin everyday in the mornings and Emergenc C packets which i don't think have biotin but have other b vitamins which i think at water soluble like biotin.

1. Do you think 700mcg daily for a few weeks or even round up to 1 mg and Emergen C packets would cause a false negative especially if early on like 45, 52 and 60 days post exposure?

2. On the labcorp form it mentions biotin effects 4th gen testing but there is no mention of biotin on the rna hiv tesr form. Does biotin effect the rna test to or is the 4th gen test?

3. On your other posts I've read you recommended people stop taking biotin 2-3 days and do another test. Which i have done yesterday and will know the results by tomorrow. But do you think it is possible i will have had a false negative test?

4. Does biotin effect oraquick test Because yesterday i took an oraquick test at strong 10 weeks and 3 days no biotin negative.

5. Out of curiosity, how many days after antibodies are detecable by blood would you estimate antibodies detecable by saliva?

6. Are there other vitamins (b12 for example)the can have similar effects as biotin in causing false negative?

I will post my test results tomorrow as well. Thank to for your help and guidance and after this round of testing i will take your advice and move forward.

H. Hunter Handsfield, MD

19 months ago

The business about biotin interfering with HIV antibody testing and maybe the AgAb (4th generation) blood tests is real, but only at very doses -- more than recommended in most conditioning programs. Even then it is rare; and in any case, the problem is gone once biotin is cleared from the system, within a few days of the most recent dose. Which you already know is our advice!

1. I don't know what doses actually cause problems, but if this dose is a standard one, I think you needn't worry at all. But you've already stopped the biotin before being tested.

2. As implied above, I think it's mainly an antibody issue, not antigen testing. Still, just wait a week so you won't need to worry.

3,4. Correct -- I'm sure you could trust your 10 week result even had you not stopped taking biotin.

5. Technically, saliva isn't tested at all. The oral fluids test depends on crevicular fluid, i.e. tissue juice from under the gums. There's a lot less antibody there than in blood, and therefore the oral fluids test misses up to 5% of HIV infections no matter now long after exposure. It's the last test that should be considered when people are worried about a particular exposure.

6. No other drugs or medications of any kind are known to interfere with the standard HIV tests.

Feel free to post your negative test result. But you already know my response, which will be to agree once again that you don't have HIV, should not be worried, and do not need any further testing.

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19 months ago

Thanks Doctor. Just to clarify I hadn't stopped the biotin prior to my 45, 52 and 60 day test i did stop it before this test i will post tomorrow.

When you say more than recommend in conditioning programs what does that mean? How much is recommend in conditioning programs?

Also given the fact i did keep taking the biotin prior to those other tests do you still think they are conclusive?

Sorry this is my last post and i will post my results tomorrow just wanted to clarify those 2 things.

H. Hunter Handsfield, MD

19 months ago

Despite the biotin you almost certainly can rely on your previous test results. I would estimate that in the 20 years of this and our preceding forum there have been at least a hundred questions about biotin and HIV test reliability. Nobody has yet reported to us that they tested positive after a previous false negative test due to biotin. (But also among the thousands of questions about HIV risks and testing, nobody has yet reported that they tested positive. You won't be the first, regardless of biotin. If and when it happens, undoubtedly it will be from a genuinely high risk exposure -- think unprotected anal sex between males -- and not a low risk situation like yours!)

I have no idea how much biotin is normal in such programs. You're the one who uses the stuff and presumably at least takes the doses recommended on the labels.

"Also given...?" Repeat question, I see no reason to say it again.

You have used up the two follow-up exchanges included with each question so that ends this thread, so there won't be an opportunity to return with your test result. Please do not be tempted to start a new thread for that purpose. Repetetive and anxiety driven questions are prohibiited and it would be deleted without reply and without refund of the posting fee -- standard forum policy. But I'll make a deal with you: if you have a positive result, please return to let us know and we'll reimburse the posting fee.

Best wishes and stay safe.

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