[Question #3883] Rapid Alere determine Ag/AB test at 51 days post exposure . Isnt this reliable ?

32 months ago
Alere determine Ag/AB test at 51 days 

Dear Doctor

At 51 days post exposure I went to a clinic and was given a rapid test. The consultant said it’s an Ag/AB Alere determine rapid test ( antigen and antibody) . I was worried but after the negative result I feel good.
However on further research on the Internet  I found out that although it’s approved by FDA it may be inaccurate during acute infection. 
My question is 
1. Is this test reliable at 51 days . I read 6 weeks was considered conclusive for 4th gen tests . I
2. Isn’t this the 4th gen test
3. Do I need to test again ? 
4. Why do some doctors say it’s not reliable in acute infection ?
5. What is acute infection ? is 51 days considered acute infection 

Is this a reliable test . I dont want to go through the worry  and stress again .

Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Welcome to our Forum.  I'll be glad to comment.  You do not mention the nature of your exposure so I cannot factor this into my response.  The Alere finger stick point of care test for HIV antigens and antibodies is a very good test although the performance is not quite as good as laboratory performed HIV antigen/antibody tests.  The few problems with the Alere test occur early in the course of infection, most typically in there first 2-4 weeks after acquisition of infection.  I would believe your test results. In answer to your specific questions:

1. Is this test reliable at 51 days . I read 6 weeks was considered conclusive for 4th gen tests . I
Correct.  I would believe your test results.

2. Isn’t this the 4th gen test
Yes, so-called "4th generation" tests are tests that test for both HIV antigen and HIV antibody.  This tet does that.  Not all "4th generation" tests however perform identically and, in general, the lab based tests perform slightly better than the point of care tests such as the ALERE finger stick tests. 

3. Do I need to test again ? 
Probably not.

4. Why do some doctors say it’s not reliable in acute infection ?
It depends on the situation and circumstance, as well as the expertise of the doctor.  I would however urge you not to go to the internet where doctors are often mis-quoted..

5. What is acute infection ? is 51 days considered acute infection
Acute infection refers tot the earliest stages of infection soon after the virus has entered the body and begun to divide.  While definitions vary, I would say that your 51 day result is beyond the acute infection stage. 

I hope these comments are helpful.  If you would like to comment on the nature of your exposure i can probably provide a more thorough answer.  EWH
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32 months ago
Dear Doctor

Thank you for your comments. They help except you’ve written 
Probably not to question 3 . Now I don’t know what to do . 
The exposure was deep kissing touching and handjob with a woman who was an escort. No oral or penetration . I also touched her vagina with my hands 
If it helps I also got a blood based test in a lab at 25 days ( 4th gen ) . I thought it was enough but I read later that it’s no use until 4 weeks. 
Given this situation would you still say probably not or something more definitive.
I hope I dont  offend you. I mean no offence. This message is asked respectfully 


32 months ago
I mean I got the second test (4th gen) at 51 days because the first one ( at 25 days) was not enough time .
Now I found out that this isn’t the correct / accurate 4th gen . It’s so stressful. 
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Thanks for the additional information on your contacts.  The contacts you describe, receipt of masturbation, kissing, touching a partner's vagina are events which have NEVER been associated with risk for HIV.  Not ever.  You are not going to be the first.  In my opinion, based on the scientific data, there was no reason for testing in the first place. 

I said probably not in my reply to number three because the choice to test is yours, not mine.  OTOH, if you want to know if there is any scientific reason for further testing, the answer is no, you do not need more testing.  I hope this is clear.  EWH
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32 months ago
Okay . So what I hear you saying is that my risk was kinda zero in the first place and that since it was 51 days - the Alere test is reliable and conclusive. Only issues with it are between 2-4 weeks.
I can move on without further testing and make love with with someone I love. I want to tell her the truth and I will. Just need to know what I’m thinking is okay 
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
You are correct.  You can move on without concern.  EWH
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