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Acute Retroviral Syndrome and Seroconversion

Oct 30, 1996

Dear Dr. Gallant, If a person infected with HIV experiences acute retroviral syndrome, does that mean that s/he is in the process of seroconverting? Would a standard HIV antibody test given two weeks after recovering from acute retroviral syndrome usually return a positive, or an indeterminate (but not negative) result? that a p24 antigen test would be positive during acute retroviral syndrome. I have also read that a p24 usually shows positive about a week before an ELISA test shows shows positive. Therefore, wouldn't two weeks be enough time to show seroconversion (via a positive ELISA result) if the person had indeed undergone acute retroviral syndrome? Thank you for all of your help.

Response from Dr. Gallant

Yes, someone with the acute retroviral syndrome is in the process of seroconverting. The best blood test to diagnose someone during that stage is a p24 antigen, a viral load test (HIV RNA), or the HIV DNA PCR.

After recovery from the acute retroviral syndrome, the viral load may fall and the p24 antigen may become negative. The HIV serology, which is likely to be indeterminate or negative during the syndrome, now becomes increasingly likely to be indeterminate or positive with time. If it is indeterminate, then it should turn positive within a month.

Your statement that the p24 antigen would be positive only one week before the ELISA sounds wrong to me. The interval is longer than a week. Therefore, while it's likely that the serology should be indeterminate or positive within two weeks of the acute retroviral syndrome, it would probably not be true 100% of the time.

reliability of ELISA for different HIV subtypes
What exactly is six months?

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