[Question #8552] Clarification

42 months ago

Hello Dr, this question is in continuation to question 8452 where you had clarified my doubts. I was not aware of some points at that time, so I would like to clarify those. None of the below questions are repetitive from my last question, I have also gone through your other forum discussions so that I do not ask questions from the scratch.

1) Biotin interference - I understand that the issue of biotin interference with 4th gen HIV tests are entirely theoretical as of now with no proven cases, is my understanding correct? Since it is an evolving topic, I thought I will clarify

2) Even in rare cases, it is most likely to be a problem in recently acquired infections, is my understanding correct?

3) I and my-ex partner have never taken any biotin supplements or multivitamins. Is biotin present in daily food items (like energy drink, chocolate malt powder, etc.) in enough amount to cause any interference?

4) Are there any other conditions, medications, or anything else that interferes with 4th gen HIV tests?

5) HIV 4th gen tests, once positive, they remain positive for life, is my understanding correct?

6) I understand that some syphilis tests can become negative due to anibiotics, however, since we had trepenomal tests too (EIA, TPHA), these tests are not affected by antibiotics and remain positive for life (unless syphilis is cured before tests becoming positive), is my understanding correct?

7) Does alochol or any other thing affect syphilis tests at all?

Thanks a lot.

Edward W. Hook M.D.

42 months ago

Welcome back to the Forum. I’m sorry you continue to worry. I’ll go straight to your questions:

1. Biotin interference in humans is theoretically and to obtain the biotin levels needed to interfere with your tests, you would need to take, and continue to take, very large doses of Biotin. Even then, this would not interfere with all the testing that you and your partner have done,

2. Correct, see above.

3. Absolutely not.

4. No

5. Correct

6. Also correct

7. No

I hope this is helpful. Please don’t worry. Time to move forward without concern about STIs, including HIV.

EWH

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42 months ago

Thanks for your reply. I would like to confirm the following point:

1) Your response regarding biotin interference (Sr No 1, 2, 3 in your response) is with respect to 4th gen HIV tests, correct?

Thanks again. I think it is time for me to take your advice and move on without worries.

Edward W. Hook M.D.

42 months ago

Your summary is correct. Please don’t worry. EWH ---

42 months ago

I have understood from our discussion that the biotin interference with HIV 4th gen tests is theoretical, even in rare cases, it affects recently acquired HIV infections & requires large doses of biotin. Thanks for clarifying it. I will take your advice, believe my test results and move on.

A final generic question - sexual activities like genital rubbing, oral-breast contact, etc are no risk activities for HIV for everyone across the globe, so whichever country you are from (for example India), these and similar activities remain no risk for HIV, is my understanding correct?

Thanks again for advising me. Really grateful to one of the top doctors of our generation. You can go ahead and close this thread.

Edward W. Hook M.D.

42 months ago

As you know, with this third response this will complete this thread and the thread will be closed later today.

No matter what the country, or whether or not your partner is infected, there is no risk for HIV from general rubbing ( frottage), rubbing a partner’s breasts, or mutual masturbation. This is the case even when partners get each other’s general secretions on one another.

Take care. EWH

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42 months ago

Is oral breast contact (sucking a partner's breast) also a no risk activity for HIV even in presence of secretions like milk regardless of country one is from?

Sorry, it was not included in the response that's why I replied in case it's still open. No more questions at all from my side.

Edward W. Hook M.D.

42 months ago

Yes. EWH---