[Question #10966] Biotin and its pertinence

18 months ago

Good Afternoon,

I apologize for asking a second question, but I feel the given the amount of subjective information on the internet, for my sake I wanted to ask:

Is there any weight to the claim that supplemental amounts of biotin can lead to false-negatives in STD tests including gen 4 HIV antigen-antibody and others?

If so, would 600-1200 mcg be a significant amount that would cause testing issues?

Thank you in advance

H. Hunter Handsfield, MD

18 months ago

I'm taking this question but I reviewed your just completed discussion with Dr. Hook. Sorry to see you back so soon and evidence of your continued obsession with an exposure that was zero risk for HIV to begin with, and with testing afterward. It's all so unnecessary!

It's an urban myth that biotin in the usual supplemental doses interferes signficantly with HIV testing reliabililty or accuracy. It does not. However, I do not know the "usual" doses and whether 600-1200 mcg might have a slight effect. In any case, biotin is rapidly cleared from the bloodstream. If you're concerned about this, just don't take it for 3-4 days before being tested.

HHH, MD

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18 months ago

So by that logic, a Gen 4 Antigen/Antibody test taken after 165 days (blood drawn on 1 February, "exposure" on 1 September) regardless of anything aforementioned would be considered conclusive, right?

Given that cases of antibodies developing after 8 weeks are near/nonexistent, I really should pay no mind to this whole dilemma should I?

Thank you so much for your advice and level headed thinking, it truly means alot.

H. Hunter Handsfield, MD

18 months ago

"So by that logic...right?" Yes, as you were also advised by Dr. Hook.

"Given that...should I?" Correct.

Thanks for the thanks. I hope you can move on without worry; and that in the event of similar exposures in the future, you won't feel the need for HIV testing.

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18 months ago

Last question, I swear!

But what makes you are colleagues adamant that this whole biotin affair is an urban myth?

I suppose looking at your past replies isn’t helping , but seeing some of studies on the NCBI is certainly pulling me all over the place.

Thank you again

H. Hunter Handsfield, MD

18 months ago

All the literature I am aware of examines biotin levels in specimens and potential interference in detection of HIV p24 antigen, which is not the same thing as finding a false negative result in a person infected with HIV. To my knowledge that has never hapened. The lab experiments show that the problem is with HIV p24 antigen detection; the antibody component of the test is unaffected. Therefore in theory conclusive testing with an AgAb (4th generation) test might be delayed 1-2 weeks beyond the usual 4-6 weeks. In other words, the concerns seem to be entirely theoretical, with potential but as yet undocumented actual effects in the real world. Perhaps you'll find this website informative: https://www.quora.com/How-significant-of-a-BIOTIN-dose-causes-interference-in-HIV-tests.

"Urban myth" might be too strong a term, but clearly this is a problem blown out of all proportion on nonprofessional websites dominated by frightened persons. But as I said, anyone who remains concerned can just stop taking the stuff for a few days before testing. What's the big deal?

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18 months ago

Dr, so even if it affects the P24 antigen, it wouldn’t even matter since the antibodies should already have replaced the antigen and be all over the place.

If so, then what a fool I’ve been.

My most sincere apologies

H. Hunter Handsfield, MD

18 months ago

Nothing to apologize about. But indeed this should no longer be an issue for you. I'm glad to have helped.

As you probably expected, that concludes this thread. Best wishes and stay safe.

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