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Please Help Me!!!!

Mar 23, 2011

Hello Dr Bob!!

I am a big fan of your work and I would be very grateful if you could answer a quick question for me.

I had unprotected sex with a new partner just over 5 weeks ago. 4 weeks ago I started getting tingling in my hands and feet, especially at night. For the last 2 weeks I have had fasiculations in my feet, legs, arms and hands. I also had swollen cervical lymph nodes for about a week.

I took a duo test at 28 days, which was negative, and have had a rapid test today at 37 days, which was negative. I am still waiting the proper lab results from today. I know the definite window period is 3 months, so I will get another test done in 7 weeks time.

In the mean time my question is this... in a seroconversion illness, would you expect the antibody/antigen test to be positive if you are having symptoms before the 3 month mark? Don't the symptoms mean that you are seroconverting and developing antibodies which should be detectable in the blood at that time?

Thank you! I really do think the work you do here is amazing and I will gladly donate to your AIDS Foundation.

from an extremely worried health care worker

Response from Dr. Frascino

Hi Extremely Worried Health Care Worker,

Unfortunately symptoms are notoriously unreliable in predicting who is and is not HIV infected. The natural history of untreated HIV infection begins with viral transmission. Acute retroviral syndrome (ARS) follows generally in two to three weeks. Seroconversion to HIV positive and recovery from ARS occurs over the following two to four weeks. There is a lag period from the time the immune system recognizes the virus and begins to produce specific anti-HIV antibodies to try to fight the invading HIV. There is also a lag period from the initial production of antibodies to the time that we have detectable levels of anti-HIV antibodies that will show up on an HIV-antibody test. This is what constitutes the window period (the period of time someone is HIV infected but has not yet made detectable levels of anti-HIV antibodies). The window period is considered to be the first three months after exposure/infection. That said, your particular symptoms are not particularly worrisome for HIV ARS.

Thanks for your support of The Robert James Frascino AIDS Foundation ( It's warmly appreciated. In return I'm sending my good-luck karma that your definitive HIV-antibody tests are negative.

Good luck.

Dr. Bob

My CD4 is below 200
How hopeful should we be??

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