[Question #6277] HIV "second diagnostic window" and "seronegative" infections. Myths?

15 months ago
Dear doctors,

Unfortunately I had to come back.

I know my results were conclusive but finally, I want to clear up all my doubts and corcerns...

Maybe I shouldn't have done it but I have been reading about HIV seronegative infections and about the controversial "second diagnostic period" in the fourth generation tests. Reading it made me think of the possibility of be a rarest seronegative infection, since I've had many abnormal symptoms as the flu-like (which I've commented on in a previous threat), including a very recurrent oral candida and abnormal swollen lymphs. Be symptomatic for so long time is associated with a rapid progression to AIDS and the COMBO tests in which I tested at 5, 9 and 13 weeks after exposure came out negative (as the seronegative infection cases). If not, be within the "second diagnostic period" where the COMBO tests cannot detect the antibodies nor the antigen.

Considering all my symptoms and the duration of them (more than 3 months and not yet gone away), is it feasible that I can be a case of seronegativity or being within the "second diagnostic period"?

Doctors, your opinion is very valuable. I want to put an end to this and move on in my life. I feel like my body is not the same as before. Thank you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
15 months ago
Wekcine back, but sorry you found it necessary. I reviewed your discussion with Dr. Hook and agree with all he said.

Test results always overrule symptoms. Your symptoms are not typical for HIV, but it doesn't matter:  your test results prove your symptoms are not due to HIV.

The supposed secondary window with the AgAb HIV tests is very rare. When it happens, it is between 2 and 4 weeks of catching the infection. All test results beyond 6 weeks alway are 100% conclusive.

So no worries about HIV. See your doctor if your symptoms continue or if they concern you, to learn the cause. It's not HIV.

Best wishes--  HHH, MD
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15 months ago
Got it, Dr.

Well, just for extra reassurance: If in some way I were an HIV-seronegative infected as those 27 reported so far in literature, would the tests be able to pick the infections as it detects the antibodies and antigen simultaneously?

Also, would it be equal in a rarest delayed seroconversion case?

Thank you for your time Dr. HHH
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
15 months ago
Your 27 reported cases is mistaken. There are none with the AgAb (4th generation) HIV blood tests. All such cases are with older antibody-only tests no longer in use. And even those cases were correctly diagnosed by finding HIV antigen in the blood — I.e. the equivalent of having an AgAb rest today.

There’s nothing more this forum can do for you. Do your best to accept the reasoned, science-based reassurance we have given. 
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15 months ago
Just one more question: Does the Klinefelter Syndrome (XXY) have any relationship with the antibody delayed production?

That's all.

Thank you doctor for your reassuring information. I think I'll be better after Dr. Hook's and your information.  Infinite thanks.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
15 months ago
I'm not an expert in Klinefelter syndrome or other genetic anomalies, but as far as I know, they have no effect on the immune system. Anyway, delayed antibody production does not alter the reliability of the AgAb tests -- that's the whole reason they are so good! If antibody isn't produced, antigen is still present and the test is positive. So for sure this has no effect oniv test reliability.

Thanks for the thanks -- that's why we're here and I'm glad to have helped. However, please note that the forum does not permit repeated questions on the same topic. This being your second along these lines, it will have to be your last. Thanks for your understanding.
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