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delayed seroconversion
Aug 23, 2000

Dear doctor, I just seroconverted after 30 months since exposure. YES, 30 MONTHS. During this period my viral load was always undetectable, I had a negative DNA PCR, a negative culture for HIV-1, but I always felt sick and my lymph nodes were always enlarged and painful and my spleen was also enlarged. The exposure was early in 1998 and I had ARS six weeks later, chronic diarrhea for five months in 1999, shingles in October of 1990 and E.coli infection in February of 2000. My t-cells dropped initially from 1100 to 600 at three months from infection and then slowly crept back up to 1300. Then, I had the shingles and since that time my t-cells dropped to 800 although I maintained an undetectable VL. My theory is that initially I had a very strong cellular response but the virus remained in resting cells which were then reactivated by the shingles. Do you have any ideas as to why it took so long?? Is it a good or a bad sign that I took so long to seroconvert?? I want to start medication because my immune system feels overtaxed (the lymph nodes in my groin are very large and painful). My doctor says they are helping me but he has not gone through the continuous pain!!..and my t-cells are dropping.

Would you treat?? I hope I do not scare everybody/Regards.

Response from Dr. Holodniy

No idea about the seroconversion length of time or prognosis. Many doctors at this point would be hard pressed to start treatment in you given your very high CD4 count and undetectable viral load.

MH



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