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asymptomatic primary infection
Aug 9, 2010

First off, I'd like to say a very big Thank you, to you, Dr Frascino for all the time and energy you devote you strangers like me! Now to the point. A few short questions: 1) How common, in your experience, is asymptomatic primary infection? Information varies out there and some sources indicate that as many as 70% of infections are asymptomatic. 2) Can you provide any information on whether asymptomatic primary infection affects in any way the window period, i.e. is it a prerequisite for delayed antibody production? 3) How often have you seen individuals who tested negative at 6 weeks turn out to be positive after a 12 week test? This last question is due to my own predicament. Had unprotected insertive vaginal intercourse with a girl of unknown status, tested at 6 weeks, got a negative result, but was advised to retest at 12 weeks. 4) Does HIV prevalence influence testing guidelines, i.e. do statistical chances play a part in setting these guidelines? Asking this because there seem to be no strict guidelines in my country regarding testing. Instead, we seem to use test manufacturer guidelines. In the end I would like to add, that you are doing a noble and brave thing! The world needs more people like you. Be well and be happy :)

Response from Dr. Frascino

Hello,

1. There is a wide array of not only symptoms but also symptom severity associated with primary HIV infection. The 70% figure includes folks who had such mild symptoms that they chalked them up to something else. Just to give you an idea of how many folks either don't have significant symptoms or, if they do, don't attribute the symptoms to HIV, 20% of the over-1,000,000 HIV-positive Americans have absolutely no idea they are infected with the virus.

2. The presence of symptoms does not affect the window period.

3. Very rarely, especially with the new generation HIV-antibody tests

4. No, "guidelines" are the same for everyone. Different countries and sometimes different agencies within a single country may have different guidelines. Most published guidelines suggest that tests taken prior to the three-month mark are not definitive or conclusive. We do know that the vast majority of HIV-infected folks will have detectable levels of anti-HIV antibodies in their blood within four to six weeks following infection. However, there are some folks who may take a bit longer for their immune system to kick into gear and produce the antibodies. Hence the three-month guideline was established.

Thanks for your kind comments.

Good luck.

Be well.

Dr. Bob



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