Question
Is the STARHS test for recent infection accurate?
4 August 2009. Related: All topics, CD4 and viral load, Newly diagnosed.
Hi
I was diagnosed with HIV in August last year and at the time of diagnosis my CD4 was around 200 and viral load was 7.5 million. My CD4% was at 21%.
Over the following 8 months my CD4 gradually rose to over 320 and my viral load dropped to 34,000. My CD4% has varied and dropped to 16% just before i started treatment two months ago.
I presumed I was diagnosed at the point of seroconversion, however after my doctor sent off my initial blood sample for the STAHRS test to see if it had been an infection in the 6 months prior to diagnosis, this came back with the response along the lines of “the sample and data suggests that this infection has not happened within the last 4 to 5 months”. I therefore wonder, although i have not discussed this in a lot of detail with my doctor why my CD4 rose after diagnosis and vl dropped and why I had a lot of the symptoms of seroconversion at the time (rash, fever, loss of apetite, fatigue etc..) at the time of diagnosis.
The nurse at the clinic did not offer any other explanation and advised seroconversion can take up to 12 months. Before i was diagnosed I had a HIV test 2 years before which came back negative. Could you help explain why everything else points to a recent infection before diagnosis but the STAHRS test provides a different explanation and how accurate the test is.
Answer
Hi
I’m not sure whether your question has been answered online yet so apologies if this comes through twice.
You are right to base your likely infection date on your history and symptoms rather than the STAHRS test result. Although this is a good test to sometimes confirm recent infections, it is not always accurate enough to guarantee the accurate result for individual patients.
Bascially it is used to batch test anonymous samples to get an idea of patterns of new infections on a population level. When it is used to confirm recent infections on an individual patient level, this information should be given to people at the same time.
Don’t worry about the negative STAHRS result. Your history, especially the high viral load last summer, and then the rapid drop to lower levels without treatment, can only be explained by a recent infection.
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