[Question #7238] Rapid HIV test after 18 months

5 months ago
Hello Doctors:

I know this might sound silly, bit last month I went to a planned parenthood in my area and has an Alere Determine HIV conbo rapid 4th generation finger prick test done.  It came back negative. 

My question is that to my recollection the last events that involved any possible exposures would have been 18 months to ten years ago. 

Would the test i had done rule out all of my previous exposures from 18 months to ten years ago conclusively, 100% full stop period end of story?  Did i take the most accurate test i could have?

Also, is the test i took identical to vein blood draw lab tests — i hate getting needles in my arm so i was attracted to this finger prick test.  Do i lose any decrement in accuracy by not doing the lab test or are they both equally definitive given the time since exposure?

Thank you 
Edward W. Hook M.D.
Edward W. Hook M.D.
5 months ago
Welcome to the Forum.  I'll be glad to comment.  The Alere fingerstick 4th generation HIV test is a very reliable test whose results any time more than 6 weeks following a potential exposure should be believed.  The performance of the fingerstick test is evaluated using the same criteria as tests performed on venous blood obtained using a needle.   Early in, years ago these tests were sometimes slightly less sensitive than venous blood tests for detection of the earliest stages of infection but those issues where successfully addressed years ago.  My advice is to believe your test results.  I see no need for further testing related to exposures which occurred more than a year ago.  EWH
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5 months ago
Thank you.  One of the problems with google is out of date information.   

In this forum, i have read replies from you doctors suggesting that for 100% conclusiveness a lab test was needed.  These are admittedly (2-4 year) older posts. 

Times and technologies change — is that the case here?

If I understand you correctly, the finger prick 4th generation test i had is equal on accuracy to a lab based test and can I also infer that you would
 not hesitate to recommend this test to people when seeking the most reliable indicator of one’ s HIV status given 6 weeks or more time since possible exposures?
Edward W. Hook M.D.
Edward W. Hook M.D.
5 months ago
Your summary is correct.  The chief difference between the Alere lab-based test and the finger stick test is the technology used.  The lab test is highly automated, making it easier to do large volumes of tests while the finger stick tests must be done individually and therefore are not time, and, as a result, cost effective in high volume settings.  It costs those doing the testing more to do the fingerstick tests.  EWH ---
5 months ago
I will use my last question here: I read on a recent post from Doctor HHH that in response to a question about accuracy of HIV tests:

Now I have read further. Guess what? Stopping after "4th Gen Ag/AB test 3 more times since them for a total of 4 tests.  3, 6, 9 and now 12 months":  It's 100% certain you do not have HIV. Full stop, no possibilty of any other conclusion. And no, nobody has ever turned positive later after even a single AgAb HIV test done at least 6 weeks after the last possible exposure.

so my question is in my case, do my AgAb RAPID tests make ANY difference at ALL regarding the applicability of the above to my question?

In other words, do these statements apply to someone who took the AgAb rapid Alere test (ME) -- that the result is 100% certain if negative that one does not have HIV and that NON ONE has ever tested positive later after a single rapid AgAb HIV Alere test done at least 6 weeks after the last possible exposure assuming no other exposures occurred?

thank you!
5 months ago
In other words, there is 0.0 need to confirm the rapid test results with a lab based vein draw as the two tests are exactly the same, if done properly, correct?
Edward W. Hook M.D.
Edward W. Hook M.D.
5 months ago
Correct.  EWH---