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HIV CMIA Test Accuracy

Keywords: HIV CMIA, HIV CMIA Window Period, HIV CMIA Method, HIV CMIA Results, HIV CMIA Accuracy

To be able to understand the answer to this question, we first have to get some basics right.

The HIV CMIA test, HIV ELISA test, HIV ECLIA test are all different methods to detect HIV antibodies and/or antigens in the patient’s blood.

I previously wrote an article on the HIV ELISA and ECLIA test.

Let me rehash some points:

To know if a person is infected with HIV or not, we look for HIV antigens or antibodies in the patient’s blood.

Antigens are a part of the protein shell of the virus. This is found floating in the patient’s blood very soon after infection.

Antibodies are produced by the patient’s immune system in response to the HIV infection. It might take some time for the patient to produce enough antibodies to be detectable by tests. This is called the window period.

Antigens and antibodies are microscopic particles. We cannot see them with the naked eye or even with a light microscope.

So scientists have developed very smart ways to let us know if there are antigens and antibodies present or not.

Click on the picture for the latest information on the HIV testing Window Period

Click on the picture for the latest information on the HIV testing Window Period

 

 

 

 

 

 

 

 

 

One method is called ELISA which is short for Enzyme-Linked Immuno-Sorbant Assay.

This is a very elegant test. Basically there is a trap for the antibodies and antigen. If these are present, they get stuck in the trap. This then triggers off a reaction that causes the solution to change colour. The colour change is indication of a positive test.

Another method is called the ECLIA which is short for Electro-Chemiluminescence Immunoassay. In the same way, the system traps antigens and/or antibodies. The difference is instead of triggering off a chemical colour reaction, it lets off light which is captured by a sensor. So basically if it lights up, it means the test is positive.

The HIV CMIA test which is short for Chemiluminescence Microparticle Immunoassay. It is very similar to the ECLIA test because it also uses light to indicate the presence of antibodies and/or antigens.

All the above is obviously a massive over-simplification of a rather complex topic. For those interested in more detailed information, there is a great resource in a learning guide developed by Abbott. Click this link to see it: learning_immunoassay

Different companies making different machines have their own patented differences in these tests so they are not all identical. However, practically speaking, these tests in themselves are exceedingly accurate. The big diagnostic companies that develop these tests have validated their accuracies very diligently.

You would have realised by now that these are all just different detection techniques. They are but one piece of the puzzle of HIV test accuracy.

These are basically tools at the doctor’s disposal. But if the tool is used wrongly, it is useless.

For the test to be accurate, we must do the right test at the right time. Doctors need to know at what point in time to use which tool to detect what.

So in summary, the HIV CMIA test is very accurate in detecting HIV antibodies and HIV antigens. There is no reason to doubt their accuracy.

However, to know if the patient is infected with HIV or not, the doctor has to know when to order the CMIA and decide if the CMIA will test for antibodies or antigens or both.

If you have any questions, visit our free online forum on sexual health, HIV and STDs.

If you had a high risk exposure to HIV within the past 72 hours, you can take medicines to reduce your risk of actually contracting HIV. Find out more on HIV PEP Treatment.

If not read more about HIV symptoms.

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400 Comments

  1. I got unprotect sex 9/17/2016 inside me n 9/21/2016 didnt ejaculation on me . I got test 10/5/2016 with hiv 1/2 antibodies (CMIA) . Its that test conclusive ?

    • No it is not. The doctor or medical person who did your test for you should have told you that. The antibody test is only conclusive at 3 months post exposure.

  2. Sir,

    I have tested for HIV 1 & 2 (ECLIA) tests after 7 days and 42 days of exposure, both turned out negative. But the values scare me. At 7 days it was only 0.08 and after 42 days it became 0.41. Should I be worried?

    • Your tests are not conclusive. HIV antibody test is only conclusive after 3 months. You should get it repeated again.
      The change in the numbers is not worrying. As long as it falls below the lower limit or abnormal, you are fine.

  3. Sir I had 4 negative test after 3 months two hiv1 and hiv2 antibody test and 2 duo antigen/antibody test but had pain in my throat and shortness of breath ,feeling tired,pain in abdomen some time left and some times right is these are symptoms of anxiety or HIV . does pneumonia treatment 13 Yeats old can affect the test accuracy plz sir reply fast I am feeling like a half dead

  4. Does 13 years old pneumonia treatment affect the immune system to delay in antibodies

  5. Im from the philippines. I had an HIV test at 5weeks and it was non reactive. On the results it was stated there that the method used is HIV 1/2 Immunochromatography..is this a good result already. Can I stop worrying already?

    • Actually the test was done at 4weeks and 5days from last exposure not exactly 5weeks… My exposure was low risk. Only penile-oral sex…. No ejaculation but really not sure about precum

    • I really do not know what kind of test you did. HIV 1/2 immunochrmatography is really too vague. There are many types of this test. So I cannot comment on the accuracy of your test. You should check this with the doctor who did the test for you. What I can say is that getting HIV from oral sex is really rare, In fact as good as impossible. Click here to read our article on getting HIV from oral sex.

      • Thanks doc. I emailed the clinic where I got tested but they are not replying yet.. Yes I agree, the info is too vague. They just put it there a lot number.. And the expiration date of Jan 2017 (probably of the test kit/method that they used…)

        I know oral sex transmission is rare.. However I have elevated anxiety due to some info I read on the forums that they acquire hiv by this route, one even say its because of his tooth cavity.

        I am also worried coz I think I have glossitis after the oral sex.. Now I have sore throat that occur after the 3weeks cough..got also tested for syphilis and it was also non reactive

  6. his Doc,

    Can a patient tested positive for dengue be mistaken if he/ she is a HIV positive ?

    Can a HIV Positive Person test Negative for Dengue?

    Are the test same for the same and how do one know they reality ?

    • I am not too sure what you are trying to ask. HIV and dengue tests are separate things altogether. They are irrelevant.

      • My question is if a person is HIV positive and goes for a test for Dengue considering high fever. Will his test be positive for dengue even if he doesn’t have dengue?

        Can the antibiotic test for dengue calculate the HIV antibodies and show a false positive

  7. Hello Doctor,

    I happened to get involved with an unknown call girl on 11th March 2016 and due to some non itchy rashes raised my concern over the HIV and hence got HIV1 and HIV2 tested in India on 11th August 2016. They used the Fully Automated CMIA test Method. The results were 0.04 Non Reactive. I still get these small boils on chest and back which reduces but takes usually more than 2 weeks to settle, no other symptoms.

    Act Date – 11th March 2016 – Test Date – 11 August 2016

    Is more another test needed to confirm the status. its really a stress moment. Please reply soon

    • In my opinion your test is conclusive. Please verify this with the doctor who did the test for you.

      • Thanks Doc. The lab dosent have any specific doc its a Lab and the test is verified by enormous doctors who are specialised but don’t meet. Do you think there is retest required ?

  8. Living with Anxiety

    Hi Doctor
    Im from new delhi , India
    I had unprotected vaginal sex on 25th June 2016. I have tested 4th generation HIV 1&2 antibodies & included P24 antigen combo (CMIA) after my exposure from india’s renowed Dr Lal Paths.
    Sir im living with anxiety since my exposure.

    My 4th generation test Test details are as below.

    1. first test done at 26day (3Weeks & 5days) result negative.
    2. second test done at 36day (5week & 1days) result negative.
    3. 4th test done at 40 days (5 week & 5days) result negative.
    4. 5th test done at 45 days (6 week & 3days) result negative.
    5. 6th test done at 56 days (8 weeks) result negative.

    I need your advise shall i go for further retest at 12 weeks?

    Im very confuesed with guildliness.

    Is it conculsuive at 6 or 8 weeks

    Needs your calarification on above pls.

    • In my opinion your tests are conclusive. Please verify this with the doctor who did the tests for you.

      • Living with Anxiety

        sir,
        I really thank so much for your quick response.
        sir,as discussed with my doctor. as per him. no need to further retest and said 8 weeks is conclusive as this 4th generation HIV 1/2 Antibodies/p24 Antigen combo CMIA test accuracy is very accurate & can early detect hiv virus at 6th week & 8th week.

        Dear sir,

        last one more question from you. Today (27-aug-2016) i went to go for my HIV1/2 ab/ag p24 cmia test at 9th & 1day week (64days) result has come non reactive (index value 0.08),FOR syphilis VDRL RPR serum test also was non reactive.

        Sir-All my tests were done from india’s reputed pathalogy doctor Lal paths which is NABL/CAP ACCREDITED,BSI ISO REGISTERED. I have not taken any risk regarding my test accuracy because i was scared as local path can give me false report with discrepancy so i have choosen this lab for accuracy.

        Sir- NOW CAN I BACK AGAIN INTO MY LIFE as i have learn alot from this high risk exposure because i was living with anxiety and depression & SCARE at all time. it will not repeat this my in future at any cost and it was first and last for me.

        i need to go further retest and 9 weeks is conclusive??

        T

      • Living with Anxiety

        sir,
        I really thank so much for your quick response.
        sir,as discussed with my doctor. as per him. no need to further retest and said 8 weeks is conclusive as this 4th generation HIV 1/2 Antibodies/p24 Antigen combo CMIA test accuracy is very accurate & can early detect hiv virus at 6th week & 8th week.

        Can move into back my life.

  9. My partner got tested positive for hiv and syphilis about 6 weeks ago.The last penetration contact between us was 5 months ago, and 10 weeks ago was the last contact which was only oral. I was at the receiving end. So I got tested rapid test thrice. Once after 6 weeks, 7weeks and 8 weeks. All negative. And now I got tested CMIA and VDRL after complete 10 weeks. And I’m tested positive for syphilis and negative for hiv. How reliable is this test? Can I now be sure that I’m negetive for hiv ? Please help. I’m worried

    • It depends on what HIV Rapid test you did. Generally speaking, at 10 weeks, most HIV tests are as good as conclusive. Please get your Syphilis treated.

  10. my wife is 9 months pregnant on 4 aug16 . her hiv test like rapid in 08 feb16 was nonreactive .recently on 22jul16 we test hiv elisa showing high range .then we test again with rapid which is non reactive. but now we test hiv 1& hiv 2and p24 combo test cmia which shown provisional reactive index value 2.36.whereas immunofiltration and immunochromatography shown negetive result.western blot is also negative.we are confused what to do pklease help

    • I empathize. That is very confusing. Pregnancy in itself can cause false positive HIV results. Your wife needs to see a HIV specialist to determine if she is truly infected or not. She may need a HIV Viral Load tests. Please see a HIV specialist for formal medical advice.

  11. I tested Elisa negative after 8 months.did cmia test after 3 years .it is also negative.is it conclusive or I have to do further test?

    • Technically your tests are conclusive. Please verify this with your doctor.

  12. shobhit

    hi sir, my cmia is repeatidly reactive (values 2.15 and 1.66 recent),

    my elisa , eclia , immunocromography and immunofiltration , western blot and rna quantitative, all are negative.

    only cmia is reactive

    times of tests : three months after exposure

    please! i beg for an advise. i am dying of anziety.

    • Your CMIA is probably a false positive. You should clarify this with your doctor. You may need more repeat tests to confirm your status.

  13. shabeer

    Dear doctor am worried about HIV before one year am contact a call girl with out Safty unsafe sex after one year am worried about it and going for a HIV 1&2 spot test card test was negative and after 2 month again go for retroviral early screen test non reactive result .20 s/co method (cmia) both test done by after one year of expose is these test enough to conclude my HIV status or need more test for a conclucive result please rply sea doctor

    • I think it is best for you to consult the doctor who did the test for you about the accuracy of the test. Logically, a HIV test done at 1 year post exposure should be inaccurate.

      • shabeer

        Inaccurate meanz not accurate ?? HIV 1&2spot test and retroviral early screen test I done after a year of expose ? Both come non reactive .test is done by my self .o
        Both test from clinic but same day evening I get result .plz rply once more am safe or not?

      • Inaccurate??

  14. sandip

    In my case i have hiv positive ?
    can i have to make another test to confirm hiv status,like that hiv rna pcr. please suggest

  15. sandip

    Sir please give ans my coment, and in my test what is the specificity >/= 99.5% meaning ?

    • Specificity defines the ability of the test to identify the disease or condition correctly. In other words, if a test is 100% specific, when the test is positive, you can be 100% sure the patient has what the test is testing for. If it is 99.5% specific, it means 0.5% of the time, the test will give a false positive. In other words, the test will tell you that the patient has a disease or condition when he actually does not.

    • sandip

      In my case i have hiv positive ?
      can i have to make another test to confirm hiv status please suggest

  16. sandip

    Dear Dr. Tan, i am from india, exposure 12.08.2015 toungue kissing unknown hiv status girl. 4th generation hiv Cmia method test done on 24.12.2015 result nonreactive. Second test 4th generation hiv Cmia method test done on 15.03.2016 result nonreactive with specificity >/= 99.5%. Third test done on 20.05.2016 4th generation hiv Cmia method result nonreactive with specificity >/= 99.5%.
    1) Is it conclusive result for hiv nonreactive.
    2) How much % nonreactive result ?

    Syptoms : muscle loss, joint pain,

    Dr. Please help me

    • You cannot get HIV from kissing. All your tests were unnecessary. That said, in my view they are conclusive. You are just being paranoid.

  17. Dear doctor Tan

    4weeks back I had performed oral sex on a female massager in a hotel at Bangkok. I am not sure about her hiv status. She looked normal though. I don’t think she had menstrual period running at that time. However I am sure she ejaculated in my mouth. I remember I did not swallow the secretion but may be little may have gone inside my mouth. I do not have any cuts or sores in my mouth. However I had brushed my teeth atleast an hour before the oral sex.
    Now it’s been 26 days and I feel very light pain in my throat. However there’s no visible swelling or redness inside my mouth. No other symptoms.
    I have taken HIV 1&2 with P24 antigen (CMIA Abbott architect) test and the report says Negative.
    I am very stressed and want to know if I have been infected by hiv. Pls advise. I will be truly grateful to you for your advise

  18. Dear doctor Tan
    Almost 4weeks back I had performed oral sex on a female massager in a hotel at Bangkok. I am not sure about her hiv status. She looked normal though. I don’t think she had menstrual period running at that time. However I am sure she ejaculated in my mouth. I remember I did not swallow the secretion but may be little may have gone inside my mouth. I do not have any cuts or sores in my mouth. However I had brushed my teeth atleast an hour before the oral sex.
    Now it’s been 26 days and I feel very light pain in my throat. However there’s no visible swelling or redness inside my mouth. No other symptoms.
    I have taken HIV 1&2 with P24 antigen (CMIA Abbott architect) test and the report says Negative.
    I am very stressed and want to know if I have been infected by hiv. Pls advise. I will be truly grateful to you for your advise
    Thanks
    VIKRAJ

  19. Dear doctor Tan

    Almost 4weeks back I had performed oral sex on a female massager in a hotel at Bangkok. I am not sure about her hiv status. She looked normal though. I don’t think she had menstrual period running at that time. However I am sure she ejaculated in my mouth. I remember I did not swallow the secretion but may be little may have gone inside my mouth. I do not have any cuts or sores in my mouth. However I had brushed my teeth atleast an hour before the oral sex.
    Now it’s been 26 days and I feel very light pain in my throat. However there’s no visible swelling or redness inside my mouth. No other symptoms.
    I have taken HIV 1&2 with P24 antigen (CMIA Abbott architect) test and the report says Negative.
    I am very stressed and want to know if I have been infected by hiv. Pls advise. I will be truly grateful to you for your advise
    Thanks
    VIKRAJ

    • Your risk of HIV is very low to begin with. Your test is a good indicator that you do not have HIV.
      Please get yourself tested again after day 28 if you are still concerned.

  20. I am having issues with weight loss of 30 lbs since Sep 2015. I have loose stools, swollen nodes less than 1cm in my neck, under armpits and groin, pain in my hands and feet and buttocks. I have tested for HIV1/O/2 five times via ICMA and fourth generation ag/ab tests and HIV 1, 2 RNA all negative. I am still experiencing incapacitating fatigue and having problems sleeping every night without medicine. My doctor doesn’t know what is causing me such distress. My last possible exposure was over 20 years ago. I thought I was conclusively negative for hiv but why am I having these symptoms?

    • drtan

      The logical conclusion is that there is something else that is causing your symptoms. You have symptoms. Nobody is denying that. But you also do not have HIV. Unless you have a logical reason to think all your HIV tests are wrong. You should find out what is really ailing you rather than keep banging your head against the HIV wall. If your doctor cannot diagnose you, get him to refer you to another doctor.

      • The only reason I can doubt my tests is that it has been over 20 years and all of these symptoms. Would these tests be still valid/accurate 24 years after any possible exposure? Thank you so much Dr Tan!

        • drtan

          Yes they would still be accurate. Anyway, if you had been infected with HIV 20 years ago, you would most probably be dead or very sick from AIDS and related complications by now.

  21. Dr Tan,

    Please can you help me to understand?

    I tested HIV by HIV-1/2& P24 combo test(abbott architect analyser) by CMIA method in India,as per your knowledge if someone tests in india by this method ,this test whether it has covered all subtypes(A-K)from M group?

    My exposure was in East africa,generally M group subtypes A,B,C,D are most common in east africa,but in india only C subtype is most common.

    Thank you.

  22. Is it possible that the CMIA result is Reactive while ECLIA result is Negative.

    What is the standard cutoff values of both test (CMIA, ECLIA )

    is it possible that the CMIA is 1.23 and Value for ECLIA is 0.122

    • drtan

      Of course. So either the CMIA is false positive or the ECLIA is false negative. They are different tests. There is no “standard cutoff”. It is calibrated for each machine in each lab and each test. The values cannot be compared against each other and also not between 2 labs.

  23. Hi doctor,
    I am in a hellish state.
    I have received unprotected blowjob, did frontage and had protected vaginal inter oust with a CSW. After which I did the following tests. Kindly assess them
    1. PCR RNA test after 12 days Detected.
    2. Chemiluminescence immunoassay test after 16 days Non Reactive.
    3. 3rd generation job test after 20 days Non Reactive.

    Sir what is your assessment of my test. Do I have job or do I need more tests ?

    • drtan

      You need more tests. It seems that the RNA PCR was a false positive. Was it a quantitative test? Do you have the viral load? If it was < 5,000 it is likely that it was a false positive. However, you need more tests to verify this. At this stage, you should be seeing a HIV specialist for proper management of your HIV testing.

  24. kenneth

    Dr.Tan,
    I would like to ask whats the difference between ELISA and CMIA?

    • drtan

      They use different techniques to detect the same antibody.

  25. CMIA test accuracy

    after the contact i had hiv 1 rna pcr test at 18 days it was not detected and on 7th week and 10th week took HIV CMIA 4th gen test
    non reactive .
    will this change after 3 months

  26. Hi Dr Tab,
    After 70 days of high risk behaviour I tested for HIV-1 RNA (20copies/ml), HIV-2 PCR (900 copies/ ml), 4th gen. All 3 tests came negative, but I had most of the symptoms related to HIV. In fact my blood count report shows that I have high lymphocytes, hemoglobin and RBC are reducing and CD8 count is higher than normal.

    • Do you think my test reports are conclusive to move on?

      • And do you think that after 70 days of possible exposure HIV-2 virus can get below undetectable limit @900 copies/ml test?

        • I do not know of an data that supports the use of RNA PCR to screen for HIV 1 or 2 infections at 70 days post exposure. Your 4th Gen test is accurate for HIV 1. To be safe, I think you should repeat the antibody tests for both HIV 1 and 2 at 3 months post exposure. Please remember that this platform is not for dispensing medical advice. Please see your doctor for formal medical advice.

  27. Not-so-worried Willie

    Is the CMIA test a 4th Gen test?

  28. hi while having vaginal sex with a part time sex worker i had a condom slip and was unprotected for 2 mins. I got myslef tested at 4,5 and 6 week by the HIV 1/2 &P24 combo test (CMIA) the result was non reactive.
    I also managed to get the sex worker tested at 3 and 5 week from exposure ( by the same method as mentioned above) and she was non reactive.
    1. Are my test 4th gen test.?
    2. Are my test conclusive at 6 week mark. ?
    3. Is testing at 3 month mark still required.?
    4. The fact that i do have a mild sore throat and cold make any difference to your assessment/ answers
    Thank you in advance for your reply.

    • 1) Yes
      2) Yes
      3) Not necessary.
      4) No difference.

      • Thanks doc for the reply.
        I just want to add that these test were conducted in new delhi india. Hope your above assessment still remains unchanged.
        Thanks and sorry for pestering you.
        ( i asked this question because doc at lab said i have to wait for 6 months to be conclusive)

  29. Doctor do drips or vaccination of any kind effect accuracy of hiv test i am talking specifically about fourth generation test which looks for both P24 antigens and Hiv 1 and 2 antibodies?
    And is fourth generation Elisa test conclusive after 37 days of exposure?

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