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Why does AIDS develop later now and in the past people progressed more quickly? (NATURAL HISTORY)
Jun 17, 2007

It says that AIDS comes out usually about 8-10 years, but in the 80s when people were infected they got it like in 2-5 years. Does it mean the virus weakened over time

Response from Dr. Frascino

Hello,

No, your impressions are incorrect. The natural history of HIV/AIDS has not changed. Rather, what's changed is our ability to recognize and detect HIV infection and also our ability to treat the illness. Years ago, HIVers presented much later in their clinical course, often at the time of an opportunistic infection. In the early years of the epidemic ("the 80s"), we had very limited therapeutic options for treatment of opportunistic infections and essentially no effective therapy against HIV itself. Consequently the disease progressed unchecked. I'll reprint a post from the archives that discusses the natural history of untreated HIV. This has not changed significantly since HIV was first identified back in the bad 'ol days.

Dr. Bob

Dormant virus (NATURAL HISTORY) Feb 10, 2007

Dr. Frascino, I am a HIV health educater and feel I pretty much have a handle on HIV and how it works. One thing that disturbs me is that I constantly hear about how a person can be HIV positive but it can lay dormant for a year before it can be detected. In other words these people claim that it could be months after exposure and the virus not be detected. Now I know the window period and I know how the test works. The alarming thing is I had a COLLEGE student tell me that this is what he heard in a college health course from the teacher. Please tell me I'm not missing something here. I'm thinking they are getting it mixed up with time of exposure to when one might actually start getting sick but they are talking about the virus not being detectable up to a whole year! Again, help me out here.

Response from Dr. Frascino

Hi,

No, you are not missing something. The natural history of untreated HIV infection is as follows: Viral transmission followed 2-3 weeks later by acute retroviral syndrome, which can last 2-3 weeks, followed by recovery and seroconversion over the next 2-4 weeks. This is then followed by an asymptomatic period of chronic HIV infection that can last, on average, 8-9 years. Following this, patients usually develop symptomatic HIV infection/AIDS. And, if left untreated, will succumb to their infection within 1-2 years thereafter.

I don't know whether the college health course was dispensing incorrect information or if the particular college student you talked to misinterpreted what he was told. (Did he happen to flunk the course???) At any rate, you can set the record straight now.

Dr. Bob



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