[Question #6335] Hiv 3rd Gen testing question

15 months ago

 Hello Dr. 

my question is concerning the hiv antibodies only test. 3rd gen 

I understand the window period as I took three test. (One oraquick advance and two blood drawn Elisa) All post one year possible exposure and were negative . I read that some condition could cause false negatives, unable to produce enough antibodies due to x linked hypo gamma globulin deficiency , seronegative infection..non Clade b ... , delayed seroconversion??

if you were unable to produce the antibodies would that make it progress rapidly? 

It has been 10 years since possible exposure 

Worried that it could have been a false negative. Plan to get 4th Gen soon but very worried my previous three test were false negatives. I read a lot of your answers on medhelp forum but curious if you have ever seen a third gen negative post two years turn positive and if I were unable to produce antibodies would I know ? 

thanks for your time

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
15 months ago
Welcome to the forum. Thanks for your confidence sin our services.

The bottom line is that your negative 3rd generation HIV antibody test is conclusive, proving you do not have HIV. To my knowledge, there has never been a proved case of HIV infection that didn’t have positive 3rd gen results 8 weeks (or for sure by 12 weeks) after acquiring the virus (regardless of HIV clade or type) — not counting persons who had taken anti-HIV drugs, e.g. for pre- or post-exposure prophylaxis. I suppose the antibody production disorder you mention could be associated with a false negative result, but if you had that you would have had a lifetime of repeated life-threatening infections and likely would be dead by now. And even without that, if you had HIV for 10 years, you probably would have had one or more serious illnesses due to cellular immune deficiency.

You’re on the right track with your plan to have an antigen-antibody (4th generation) test. The negative result might be more reassuring than anything I can say.

I hope these comments are helpful. Let me know if anything isn’t clear.

HHH, MD
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15 months ago
Thank you Dr for your reply. 
As far as if you were unable to produce antibodies would that cause one to rapidly progress to AIDS? 
Also, I recently went to my PCP with my concerns and he said he had experience with Hiv patients. He checked for swollen lymph nodes, liver and spleen and said everything looked and sounded good as well as lungs. Is this reassuring as far as HIV for 10 years goes?  
Would waiting two years to test be to late? 
Thanks again for your time. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
15 months ago
There is no such thing as someone "unable to produce antibodies", except for the rare genetic disorder (and related conditions) you mentioned above.

A normal physical examination is only soft evidence against HIV; it makes it slightly less likely, but that's all. However, for the other reasons discussed, there is no realistic chance you have it. But I stand by my advice to be tested. There is no such ting as too late to test. HIV infected people have positive tests for life.

I will be happy to comment again if you have an AgAb (4th generation) HIV test. I will have no other comment of any kind unless and until you return to report such a test result. Do it within 2 weeks, at which time this thread will be closed. I do hope the information so far has been helpful. 
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