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When will sero conversion end?
Dec 12, 2003

I am a 37 year old healthy male who has been recently diagnosed HIV+ and went through the acute illness about 2 months ago, I feel fine now except for pain and swelling in lymph nodes that will not disappear. Any basic description of the acute phase states " a few days to weeks of illness", so I am curious why my lymph nodes are being so persistent. The actual illness was not very severe. Is this fairly common or should I be worried. Thank you for your efforts with the forum as it is helping me loads!

Thanks, Jason

Response from Dr. Frascino

Hi Jason,

Persistent generalized lymphadenopathy (swollen, often tender lymph nodes) is a relatively common phenomenon following recent HIV infection. It may not be bad news. The lymph nodes are part of your body's immune defense mechanism. In essence, your lymph nodes are fighting for you. You indicate that you experienced ARS about two months ago. One option to consider would be taking antiretroviral medications, if indeed your infection (not just the diagnosis of being positive, but rather the actual acquisition of virus) is recent. Distinguishing recent (acute) from more long-standing (chronic) infection can be done via specialized testing ("detuned ELISA testing"). There is some rational for instituting HAART during acute infection. Some lines of research indicate this may preserve your body's HIV-specific immune response and possibly help you fight the virus more effectively over time. Talk to your HIV specialist to determine if this is an option for you. The potential benefits of starting therapy would have to be weighted against the inconvenience of taking the drugs, as well as the possible drug side effects and toxicities.

I mention this option not only from a potentially beneficial immune response perspective, but also because, if the viral load, which is often very high during acute seroconversion, is brought quickly under control, your swollen lymph nodes may recede quickly as well.

Jason, there is no one correct answer here. I merely wanted to make you aware of your potential options. One more thought: if early treatment is not an option for you, or if you choose not to start it, and if your lymph nodes continue to be swollen and tender, they should be evaluated by your HIV specialist. Opportunistic infections and malignancies would need to be considered.

Good luck, Jason.

Dr. Bob


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