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why anti body?

Question: 

hello, I have been wondering about this and it makes no sense to me to test for antibodies rather then the actual virus.
Why is it that most clinics prefer to test for antibodies rather than the virus itself. Also there is not enough education about prep. In my case after a risky activity, I ended up waiting six weeks for an antibody test and now I have to wait another4 1/2 months according to my dr to be conclusive. I didnt even know a thing like prep existed. In addition, i am so freaking nervous after getting my negative at six weeks. I started feeling sick right after I got my negative result. I had a sore throat for a day or two and a small bump on the left side of my neck. Im so nervous i dont even want to go back. It is very hard to deal with the stress and anxiety of having to go and re test....is it possible that my test was accurate after six weeks?

Answer: 

Hello, and thank you for contacting the AIDS Vancouver Helpline. I understand you are concerned about your test results. I will be glad to help.

To answer your first question, the reason antibody tests are widely used is because it is more accurate than looking for the virus itself. The levels of the HIV virus initially spikes following the infection, but is then quickly decreased by the immune system. Therefore, looking for the virus may be a hit or miss based on the length of time after infection. However, the levels of antibodies against HIV will become detectable usually around 3-4 weeks, and will stay detectable indefinitely after the infection. Therefore, it is safer to look for antibodies after the window period, rather than looking for the virus. Another reason could be that to test for the HIV virus blood must be drawn, but antibody tests can easily be done just using saliva, since we secrete antibodies in all bodily fluids regardless of presence of the virus. There is now a highly accurate test (4th generation combo test) available that tests for both antibodies and the P24 antigen (a part of the HIV virus).

As far as the lack of education for Prep, I totally agree. Here in AIDS Vancouver we try hard to spread this education, both online and in person. We are also fighting to make Prep free of cost, since it is quite expensive and therefore inaccessible to many people.

Now, let's talk about your test. Your negative result at 6 weeks is a very strong indication that your HIV status is negative (over 95% accurate). According to World Health Organization, for a test to be conclusive , it must be done 12 weeks after exposure. You do not have to wait 4 1/2 months. Also, your test after 12 weeks should likely come back negative, and it would be very unlikely for your status to change. Now, as far as your symptoms, we do not use any symptoms to diagnose or indicate an HIV status. This is because more people don't show any symptoms related to HIV, and in the cases that they do the symptoms vary greatly from person to person, and in many cases they can be simply due to other infections such as a cold, flu, allergies, or even stress. The only accurate way of knowing your HIV status is by testing.

I hope I was able to answer your question. Please feel free to contact us again for more information.

Sincerely,

Ali

AIDS Vancouver Helpline/Online
Monday-Friday 9am-5pm (PST)
1 844 INFO-HIV (Toll free Canada & U.S.)
helpline@aidsvancouver.org
Private & Confidential

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