There is life with HIV

Is the 60-day HIV immune window reliable?

Rapid fourth generation HIV test, 30 to 60 days reliable? Is this immune window enough?

A janela imunológica de 30 dias, para testes contra HIV é confiável, mas é preciso considerar fatores externos
In the case of this image, we have a test with positive serology, reagent, for HIV. Or seropositive

Immune window of 30 to 60 days it's trustable? The 4th generation test is reliable, can I rest easy?  What is the immune window period for HIV testing? I have answered this question for many years and now I have new data that I need to publish. Read, reason and understand. If you need, talk to me. Or with Beto Volpe.

We are here to help!

 

Is the 30-day immune window reliable? Yes. But there may be errors in that. There are crucial points to understand.

If you need to understand the answer to the eternal question: “30-day immune window is reliable”, you need to take these factors into account, as crucial! 

  • Modern HIV tests are able to detect most of infections in one month after exposure.
  • They can detect almost all infections within two months.
  • Fourth-generation lab tests have shorter window periods than rapid tests and self-tests.

Is the immune window of 30 to 60 days reliable? Yes, but you need to be aware of a number of details and, please keep in mind that the SUS test and doctors are reliable, the brands may vary, but the methods, the reagents, the non-reagents and, unfortunately, the undetermined results for HIV tests are, in summary, all the same, with identical methodologies. try to keep in mind that they are always the same antibodies, specific to the same virus, that we look for in these tests.

Therefore, you do not need to go from one CTA to another, for new and repeated tests. An unnecessary drama and, let's face it, the country is very, very badly directed when it comes to health and, unfortunately, resources are scarce and scarce. Porconaro doesn't care (anger).

The window period refers to the time after infection and before seroconversion, during which infection markers (p24 antigen and antibodies) are still absent or too few to be detected. Tests cannot always detect HIV infection during the window period.

All tests have an immunological window period, which varies from test to test. It also depends on the sample being tested: window periods are usually reported based on a blood plasma sample, but are longer when the sample tested is finger-pricking blood or oral fluid. 

Plasma is the colorless fluid part of the blood, separated from whole blood using laboratory equipment. The blood from the finger prick is produced by puncture the finger with a lancet, while the oral fluid is obtained by cleaning the gums.

There are two key questions to ask about a specific HIV test: 

How long after someone is exposed to HIV, can the test detect whether they have become HIV positive? 

How long after exposure to HIV can an individual be sure that a negative test indicates that he or she does not have HIV? 

What do the guidelines say about the 30-day immune window period?

UK guidelines state that a fourth generation HIV test, performed on a blood plasma sample in a laboratory, will detect the vast majority of HIV-infected individuals after four weeks (28 days) after exposure.

People who test for HIV, who see possible exposure in the previous four weeks, should not be forced to wait before the immunological window period to get tested for HIV, as this can miss an opportunity to diagnose HIV infection, particularly the recent infection, during which a person is highly infectious, and an existing infection

They should receive a fourth generation laboratory test for HIV and be advised to repeat it when four weeks have elapsed since the time of the last possible exposure to HIV.

A negative result on a fourth generation performed four weeks after exposure likely to exclude HIV infection. The guidelines suggest that additional testing is generally not necessary unless exposure is believed to present a high risk of infection.

Individuals at continuous risk of HIV infection should be advised to retest at regular intervals, always observing the immunological window.

How long are the immunological window periods of different HIV tests?

It is difficult to say exactly how long the window period lasts, as there are variations between individuals and it is a difficult topic to research, newly infected people would need to know exactly when they were exposed to HIV and then provide several blood samples during the following days and weeks. . Thus, if the 30-day Immune Window is reliable, it will always depend on other factors!

However, a study by Dr. Kevin Delaney and colleagues calculated window periods for a series of HIV tests. 

All of these analyzes were based on plasma samples. Window periods tend to be several days longer when testing samples of finger-prick blood or oral fluid, as would be normal when using rapid tests at points of care and self-testing devices. Unfortunately, accurate figures for how long window periods are have not yet been published.

The researchers' analysis confirms that fourth-generation laboratory tests (which detect both antibodies and the p24 antigen) detect HIV infections between one and three weeks before the oldest antibody-only tests. In addition, their data suggest that guidelines in some countries that recommend a new test 90 days after possible exposure to HIV are more cautious than they should be.

Um fourth generation lab test it is recommended in the UK and US guidelines as well as in Brazil. It uses a plasma or blood serum sample and can detect immunoglobulin G (IgG) antibodies, immunoglobulin M (IgM) antibodies and viral p24 antigen (a protein contained in the HIV viral nucleus that can be detected before the antibodies). Commonly used tests of this type include Abbott Architect HIV Ag / Ab, GS Combo Ag / Ab EIA e Siemens Combo HIV Ag-Ab.

  • The period medium of the window is 18 days (interquartile range 13 to 24 days). This indicates that half of all infections would be detected between 13 and 24 days after exposure.
  • 99% of HIV-infected individuals would be detectablewithin 44 days after exposure.

Um fourth generation rapid test is available (Determine HIV-1/2 Ag / Ab Combo). Although the results of this test when testing plasma were largely similar to those of equivalent laboratory tests, the window period is likely to be several days longer when testing blood by finger prick (on your finger), as the test is normally used.[/ Vc_column_text]

Pay attention The Immune Window period is Medium and Yes, the immune window of 30 is reliable, but in some cases, may be subject to errors!

But not the temporal catastrophes of years and years. these cases do exist, but they are infinite rarities.

Some rapid third generation testing at the service location are available. They can detect immunoglobulin G (IgG) antibodies and immunoglobulin M (IgM) antibodies. Examples include HIV testing INSTI HIV-1 / HIV-2 e Uni-Gold Recombigen . The estimated window period for the INSTI when testing plasma is as follows:

  • The window period mean is 26 days (interquartile range 22 to 31 days). This indicates that half of all infections would be detected between 22 and 31 days after exposure.
  • 99% of HIV-infected individuals would be detectable within 50 days of exposure.

"A negative result in a fourth generation test carried out four weeks after exposure is very likely to exclude HIV infection."

The immunological window period can probably be several days longer!

However, these estimates were based on plasma tests. In practice, tests are usually done on finger-prick blood and the window period is likely to be several days longer.[/ Vc_column_text]

Third generation laboratory tests are no longer recommended for use. They can detect immunoglobulin G (IgG) antibodies and immunoglobulin M (IgM) antibodies, but not the p24 viral antigen. Its window periods are similar to those of the INSTI rapid third generation test (plasma samples), but a little shorter (average 23 days).

Many quick and immediate tests are described as second generation. They can detect immunoglobulin G (IgG) antibodies, but not immunoglobulin M (IgM) antibodies or p24 viral antigen. 

Since these two substances are detectable before HIV infection than IgG antibodies, second-generation tests have longer window periods. Examples include OraQuick Advance Rapid HIV 1/2, Clearview HIV 1/2 STAT-PACK and SURE CHECK HIV 1/2.

  • The average window period is 31 days (interquartile range from 26 to 37 days). This indicates that half of all infections would be detected between 26 and 37 days after exposure.
  • 99% of HIV-infected individuals would be detectable within 57 days of exposure.

However, these estimates were based on plasma tests. In practice, tests are usually done on finger-prick blood or oral fluid and the window period is likely to be several days longer.

Self-Test Devices and Immune Window

No self test device was included in this study. However, most self-tests are modified versions of quick and timely test kits that were originally developed for healthcare professionals. Most are based on second-generation tests, so they are likely to have relatively long window periods. Some, including those from INSTI HIV self-test, based on a third generation test.

Likewise, the self-testing has not been included. In the UK, this usually involves sending a blood sample from a finger prick to be tested in a laboratory with a fourth generation antibody / antigen test. Plasma is extracted from the sample by centrifugation. In theory, the test will be as accurate with plasma from a self-collected blood sample from the finger prick as with venous blood, including for acute (recent) infection.[/ Vc_column_text]

Immunological Window and Scientific Texts. Are these numbers always accurate?

In some situations, these numbers should be interpreted with caution:

  • When testing is done with blood samples from the finger or oral fluid (instead of blood plasma), the window periods are likely to be longer.
  • Individuals on pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) may experience a delayed antibody response, extending the window period
  • The data are based on individuals with HIV-1 subtype B (the form of HIV most commonly found in western countries) and tests may be less sensitive to other subtypes.
References

British Association for Sexual Health and HIV. BASHH / EAGA statement on the HIV window period, 2014.

Delaney KP et al. Time to reactivity of the HIV test after HIV-1 infection: implications for the interpretation of test results and retest after exposure. Clinical Infectious Diseases 64: 53-59, 2017.

Delaney KP et al. Time from HIV infection to earlier detection for 4 FDA approved point of care tests. Conference on Retroviruses and Opportunistic Infections, abstract 565, 2018.

Artificial Intelligence Suggestions Is the Immunological Window 30 reliable?

  1. What does seropositive mean
  2. HIV or AIDS? I'm a Reagent, now what? Life goes on!
  3. A Stamp contaminated me - I am a seropositive in Sampa!
  4. HIV Infection Signs and Symptoms - Linking to Rash
  5. The Immune Window, A Sad Chat With Anonymous
  6. Acute HIV Infection, Immune Window and Clinical Latency.
  7. CD4 Know What It Is And Understand Why Blood Count Does Not Assess Immunity!
  8. Undetectable Viral Load gives No Reagent?
  9. Pre-Natal HIV Testing: All Pregnant Women Must Do
  10. Eternal Immune Window or HIV Phobia

There's one more thing for you to take a look at the link below, about the blessed folliculitis

So, if you ask "is the 30-day immune window reliable?" remains difficult to understand, the ideal is to talk to a doctor. And with us! Thanks for reading, for trusting and everything. I hope that the questions about the reliability of the tests, in front of a window immune response from 30 to 60 days are better answered. henceforth. 

Immune window of 30 to 60 days it's trustable?

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1 comment. It is good to have the debate started!
  1. Claudio Souza You say...

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