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OK Guy
Mar 20, 2001

What did you mean in a recent answer to an individual (Feb) that "it may be possible to test too early during acute seroconversion."? I was recently tested twice after a probable recent exposure to HIV and the ELISa came bace positive both times, and the Western Blot came back "indeterminate both times." My doctor started a regimen of medication treatment after additional lab work indicated my viral load was 56,000+. Was medication treatment warranted this early given my results, numbers, and probable "recent" exposure/infection?

Response from Dr. Pavia

Good question. You almost certainly were very early in infection (because of the indeterminate western blot and recent exposure), but definitely infected (because of the high viral load). I also would have suggested starting therapy at that point, for the reasons that have been discussed here many times about the possible benefits of starting during primary infection. We believe (or hope, based on early data) that it will preserve the ability for your immune system to control the virus later on. It is a decision you have to make on the spot, because like primary infection is a little like virginity, you have only one chance to make the decision.

What I was talking about is the fact that there can be a window between the time one is exposed and when the tests become positive. Typically, the PCR test for viral load becomes strongly positive between 7 and 21 days. The EIA is next, with most people being positive by about 21 days, although we know that it can rarely take up to 3 or even more rarely 6 months. The Western blot lags behind, and is the last to become convincingly positive.

So, if you had a high risk exposure 10 days ago, it is usually too early to trust and HIV antibody test, and even the viral load may still be negative.

Hope that clears it up

ATP



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