[Question #6642] Clarification on Ag/Ab

12 months ago
Good day Doctors,

Unfortunately I am back with clarification questions. To update you, I have been doing very well after the last time we communicated but then that thought bug hit me again after reading on here about confirmation testing. 

So on the 10th week, I received another Ag/Ab 4th Gen Blood Drawn from Vein test with Quest. Received results of non-reactive as I was expecting after our last conversation, later that evening. 

That is a Non Reactive on the 6th and 10th week. So Doctor, here is my question that is needed for clarification for Ag/Ab process. 

1) To be more clear on how the antigens and antibodies work. Using the 10 week mark, by this time, if Antibodies are not present, Antigens definitely are ( or Vice versa) correct? 

2) The old rule of 3 month confirmation testing is specific for only the Antibodies test? (3rd Gen)

3) Both of my non-reactive tests at 6th and 10th week (42 and 69 days) would be absolutely conclusive?

Doctor, I know my scenario was considered a no-risk event, but honestly the secondary testing was more for the “confirmation” of the previous test. 

Hope to hear from you shortly. 
Thank you in advance. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
12 months ago
Sorry you found the need to return. It was unnecessary:  these questions were answered or are obvious with a little thought from your previous two discussions with Dr. Hook.

1) HIV antigen appears in the blood 10-20 days after infection. Antibodies then develop and clear the antigen out of the blood. Once the AgAb test is positive -- usually by 3 weeks and always by 6 weeks -- it remains positive for life, because Ab, Ag, or both are present. There are no exceptions.

3) Three months goes back to older antibody-only tests no longer in use. It doesn't apply anymore, except for the antibody-only oral fluids test.

3) Yes. Re-read the other threads.

This thread will be open for one more follow-up or deleted tomorrow, whichever comes first. Do not ask anything already answered; we will not keep repeating ourselves.

Please note that the forum does not accept or reply to repeated questions on the same topic, especially when obviously anxiety driven. This being your third along these lines, it will have to be your last; such repeated questions will be deleted without reply and without refund of the posting fee. We have found that allowing repeated questions tends to prolong anxiety, not relieve it -- there's always a "yes but" or "could I be the exception" sort of question, to which the answer always is no. Finally, such repeated questions are of limited use for education of other users, one of the forum's main purposes. Thanks for your understanding of the policy. I do hope this and your previous discussion have been useful and help you move along. Best wishes and stay safe.

12 months ago
Truly a pleasure to be able to speak to you Dr. HHH. 

Thank you for your response and I am as annoyed or even more for that matter that I came back for another question, please believe that. 

I appreciate your answer on AbAg timeline and how it works  in the body. It is the conflicting information out there that your logical side says , no but your curious side says huh. 

Now I know that either Ab or Ag or Both is in the body by 3-6weeks, no exceptions, and can be detected.

And my 6 & 10 week non reactives are conclusive. 

Doctor, what would you recommend for me to get over this insanity? I have never in my life dwelled on something sporadically like I have on this subject. It’s not everyday but just pops in my head every so often. I just don’t get it sir. 

Misinformation with “2nd window period” can drive a person mad. 

I know this is my last one so thank you and if Dr Hook sees this as well, thank you sir. 

All the best gentlemen. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
12 months ago
Thanks for the kind words. But my advice is no different and no more expert than what you learned from Dr. Hook. He deserves your equal respect.

"...what would you recommend for me to get over this insanity?" This is a psychological issue and we are not psychologists. Sometimes such feelings are due to an underlying emotional reaction to a regretted sexual decision, but I have no way of knowing what the trigger has been in your case. Professional counseling would be a good idea if you remain fearful despite your intellectual understanding that your results are reliable.

"Misinformation with '2nd window period' can drive a person mad." Secondary window is controversial and very rare, if it occurs at all. If it happens, probably it would last onluy 2-3 days between 4 and 6 weeks after infection. It is never an issue beyon 6 weeks. Stop searching the internet about this or any other aspects of HIV testing. The web often is not a friend to anxious persons. The famous staistician Nate Silver (fivethirtyeight.com) wrote a book ("The Signal and the Noise") in which he writes (approximate quote): "Give an anxious person a computer with an internet connection in a dark room, and soon he'lll believe his cold is the bubonic plague." You're being drawn to information that stokes your fears and missing the reassuring information that also is present. Give it a rest.

Best wishes and stay safe.