[Question #2085] Wondering now

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83 months ago
 Good morning Dr,

 I had posted before regarding my situation which is now over six months back    I had taken several fourth-generation test literally every month open till today shy of 21 weeks   

 Are all four generation that based tests from quest diagnostics.  They were all negative and that is great news regarding my situation   

 I have a tremendous amount of stress and anxiety over the past 6 1/2 months now and I just happened to be glancing through some of the thread on the forum      

 So my question is in regards to Dr. Hans field stating that for weeks may not be conclusive for a four generation test and then the asker stating that his path all a just a saying it could take six months to a year   

 Does this mean that I need to continue to test as I didn't take a six-month one in the year has not yet come   

Dr. Hans field what does your data Reveal based on the comment you made and I hope to hear back, thank you so much for your time


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Edward W. Hook M.D.
83 months ago
Welcome to the Forum.  As you probably know, clients on this site are not permitted to request who responds to their questions.  All questions regarding herpes go to Ms. Warren and Dr. Handsfield and I split all other questions.  As it happened, today I happened to pick up your question.  As an FYI, having worked closely for more than 35 years, Dr. Handsfield and I never disagree on the content of our replies although our verbal styles vary.  I will be addressing this question.

I think you may have mis-interpreted what you read.  We have consistently indicated to clients that combination HIV antigen/antibody tests provide conclusive results 4 weeks after exposure and by 8 weeks antibody only tests are conclusive.  Any testing beyond 8 weeks after exposure is really unnecessary and really is a waste of your time and money.  You can be confident in you results and do not need further testing.  EWH

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83 months ago
Thanks Dr. Hook
Sorry about grammatical issues earlier as I was speaking into my phone. I understand that both yourself and Dr. H both have stood by the 4 week duo reliability, but to be clear the thread I am speaking of is titled, "

[Question #2022] Reporting back with HIV test result"

In the post in the third comment Dr. H states that he has seen data that may reflect that a 4th gen is not as conclusive as he has been stating for years at 4 weeks. To be clear I myself have taken 4th gen tests for a total of 8 times at various intervals up to 146 days or 1-2 days shy of 21 weeks. These were all negative, and I was finally letting my anxiety subside until I saw the above comments. 

Here are my questions. 

1. Is 6 weeks then definitive, would I need to take one now which would be 6.5 months later? Reason I ask is that the thread mentioned above states that a pathologist told the client that a term "Long tail" could be up to 3 or 6 and even 1 year even with a 4th gen test

2. Could there be any chance an infection could have been missed after 8 tests up to 21 weeks. 

3. Do you know what data Dr. H is referring to? His stance may want to change to 6 weeks or longer?

4. Can I forget about this and any potential rare case occurrence in myself?

Note- I never experience classical ars symptoms but did develop acid reflex or wei D mouth sand paper feeling from time to time which comes and goes. Tremendous anxiety and stress could have caused that for me. 

Thanks for the additional time
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83 months ago
Just so you know that question I was referring to was just a few questions before this one. 
Thank you
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Edward W. Hook M.D.
83 months ago
Thanks for your follow-up.  Dr. Handsfield and I have communicated about this.  The data which are not yet published seem to indicate that there are a small proportion (a few percent or less) of persons who acquire HIV and yet have not had a positive combination HIV antigen/antibody test until 42 days.  As you consider this, please remember that CDC has traditionally been slow to change there recommendations which have tended to be conservative.  These new data do not change your situation in which you have negative tests out to nearly six months.  I continue to be completely confident that your tests prove that you did not get HIV from your encounter of concern and that there is NO need for further testing.  Thus, in answer to your specific questions:

1.  See above, your results are definitive.  The "long tail" that Dr. Handsfield refers to goes out to 6 weeks, not 6 months.
2. No,believe your results.
3. Our recommendations may change to reflect these new findings.  We will first carefully examine the data.  If and when we change our stance, we will still emphasize that the vast majority of persons who acquire HIV have positive tests at 4 weeks.
4.  Yes, I urge you to not worry about these rare cases and move forward.  You have negative tests long after you results were definitive.

Thanks again for raising this issue. Take care.  EWH 
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83 months ago
Thank you Dr. Hook,

Just to be clear, i had actually lost count of my testing. The reality is that i had 11 tests all 4th Gen blood drawn from the arm at Quest Diagnostics. 24, 31, 39, 48, 55, 61, 69, 80, 90, 116 & 146 Days. All were negative!

Questions on this last comment

1. Are you serious that i should not test any more? Even the lab itself had a doctor call me after i wanted to go for another test and he essentially called to tell me not to waste my money and that if i had it, the test would have shown it by now. Have you ever counseled people on how to best let it go? Seems like i keep going back to google and looking at rare cases and now that post which stated by Dr. Handsfield that he is not that confident in 28 days.

2. Is there any likelihood that all those tests missed anything?

3. I have seen comments on posts where you state that a single 4th gen test could be false negative but having taken an RNA test along with a 4th gen would be absolute proof by 28 days. Based on that can i consider that i have taken 11 4th gen tests as unequavocle proof that there is no infection and i should move past this? I'm just scared as they were just 4th gens and not a mixture of two different tests.

4. P24 or Antibody would not be missed over these tests? Are you completely confident?

5. To your knowledge are Quest Diagnostics 4th generation tests good tests?

I am honestly ready to move past this mentally and i more than anything want to. I feel when i get responses from you or my post from a few months back  give me a good sense of confidence until i read something again.

I understand alot of this is repetitive but as you can see i feel perhaps anxiety/worry is winning my mental fight right now.

Thank you and i hope to never ever ever ever ever have to post on this site again.

I commend you on your work, thanks again.
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Edward W. Hook M.D.
83 months ago
You are correct that your anxiety is getting the best of you.  You are likewise correct that your questions are repetitive.  Asking the same questions will not change the answer.  Brief responses below:---
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Edward W. Hook M.D.
83 months ago
Apologies, I hit submit too quickly.  My answer continues below:

1.  Yes, I am completely serious.  Further testing is a waste of time and money.  Going to the Internet for "information" is a foolish thing to do and will mislead you.
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Edward W. Hook M.D.
83 months ago
2.   There is no likelihood that an infection has been missed.

3.  Your fears are irrational.  Believe the result.

4.  Repetitive.  Believe your test results.

5.  Of course the tests are good.  Qwest is a reliable lab.

Thanks for your thanks.  This will complete this thread.  Please understand that additional repetitive questions can be deleted with no response.  I wish you the best.  Please accept your test results.  EWK
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