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Question #1: Severity of AVS Question #2: Oral thrush and swollen lymph nodes
Apr 15, 1997

Hi Rick. Have any studies explored the relationship between the severity of AVS and time to seroconversion? I would think a more severe acute illness may trigger antibody production more quickly. How about severity of AVS and time to symptomatic stage? Is AVS caused by the body's efforts in defending itself or from a rapidly declining T-cell count? Thanks

Rick, Let me start off by saying that you provide an invaluable service to many folks and are doing a fantastic job at answering the questions to the best of your knowledge. I guess I have a couple of questions that do not seem to be all that clear to me. They all have to do with the period shortly after infection. First of all, how can you distinguish oral thrush? Secondly, how do you distinguish if your lymph nodes are swollen enough for concern? I know that it would be systematic, but which glands are affected the most and to what extent? Will they be painful, irritated and swollen? How long does it last and can it go unnoticed? Lastly, is there a percentage you can put on a six week test. I keep reading that the average is 25 days and the usual is three mon ths. What percent convert between this time frame. Any help clarifying these issues would be greatly appreciated.

Response from Mr. Sowadsky

Hi. Thank you for your questions.

Acute Viral Syndrome, Seroconversion, and the onset of chronic HIV/AIDS symptoms are 3 different time points in HIV infection. One is not dependant on the others. For example, the severity of Acute Viral Syndrome is not directly linked to the time of seroconversion and the time on onset of chronic symptoms. Each is highly variable from person to person. Having a severe case of Acute Viral Syndrome does not necessarily mean the person will seroconvert any sooner, nor does it mean they will come down with AIDS any faster than other people. Acute Viral Syndrome is a general response of the body against HIV. In fact, Acute Viral Syndrome is not unique to HIV/AIDS. This syndrome can also occur in other illnesses as well. For example, in persons recently infected with the Herpes Simplex virus, they can have this syndrome during their first outbreak of the infection. Acute Viral Syndrome is therefore a general response of the body when fighting against many types of recent infections (not just HIV).

Thrush is not a symptom of Acute Viral Syndrome. It is normally found when the chronic HIV/AIDS stage begins (which is an average of 10 years after infection). It would appear when damage to the immune system begins. Thrush appears as a thick, whitish, cheesy coating in the mouth (especially the tongue) that can be scrapped off. It is NOT just having a whitish tongue! It is a distinct thick coating in the mouth. Only a doctor or a dentist can diagnose thrush. Since thrush can be caused by causes other than AIDS, having thrush by itself does not indicate HIV infection. But we do recommend HIV testing in a person with thrush, just to rule of HIV/AIDS as a cause.

If a persons lymph nodes are larger than usual, especially if they are tender to the touch, or if they remain enlarged for longer than 1 to 2 weeks, please see your doctor. Your doctor can tell you if your lymph nodes are abnormally large or not, and can show you exactly where on your body they are located. Generally speaking, lymph nodes are located in the neck (under the jaw), under the armpits, in the groin, and at other sites around the body. Remember a person with HIV may or may not have swollen lymph nodes. If they are enlarged (in persons with HIV/AIDS), they are usually enlarged at several areas around the body. Enlarged or tender lymph nodes do NOT indicate HIV infection, in of themselves. MANY other medical conditions cause this exact same symptom. Please do not diagnose yourselves on what you believe are swollen lymph nodes! See your doctor if you think anything is abnormal.

The posting, "A MESSAGE FROM RICK SOWADSKY ABOUT SYMPTOM QUESTIONS" discusses the time points of when symptoms begin, and more about what these symptoms are. Further information regarding the time points of seroconversion can be found in numerous questions in the HIV testing section (in the previous questions area), and in the question, "Realistically ??" If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).



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