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AVS/Seroconversion/Elisa -
Feb 28, 2000

Thank you for all the wonderful advice already posted. I have looked through many answers so as to not ask the same questions again however I have yet to find these specific questions addressed.

1) My understanding is that antibodies detectable by Elisa are only present after seroconversion and that AVS (assuming it occurs) is always associated with Seroconversion. If Seroconversion always proceeds a positive Elisa than wouldn't AVS (assume you were assured of getting it)also ALWAYS have to occur PRIOR to a positive Elisa? For example is it at all possible to get a positive Elisa at say 5 weeks and than get onset of genuine AVS at 6-7 weeks or is this out of the question.

2) I had a sore throat/swollen glands occur at 45 days followed by a fever at 50 days. I understand anything can happen however in most instances wouldn't a fever occur ahead of or at the same time as swollen glands/sore throat? Have you ever seen patients with symptoms of AVS in this order (ie. fever mid to late stage AVS)?

3) Finally, in your own clinical experience how frequently does AVS occur beyond 6 weeks? Is it correct that average onset of AVS is 2-3 weeks and that probably 90%+ patients would experience onset of AVS (assuming they experience AVS at all)within 6 weeks of exposure. I understand that no hard data is likely available however some insight/understanding from your own observations would be much appreciated and valued.

Thanks for the insight.

Response from Dr. Holodniy

1. It would be extremely unusual to develop antibodies first and then develop symptoms. The symptoms are usually a sign of virus in the blood/lymph nodes. Once antibodies develop and get rid of virus, the symptoms go away. If the exact point of infectious contact is known, unlikely that symptoms would develop after 6 weeks. Fever is usually a component of this and I suspect you had low grade fever first.

MH



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