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question on delayed seroconversion
      #134783 - 02/22/05 10:11 AM

In my daily consultation and test job, I encounter many worried wells who have difficulties in understanding the rare cases in history who took more than six months to seroconversion.

By literature research, I found that:

1) There are a few documented cases who seroconverted more than three months after exposure. Among them, there are two documented cases who experienced acute illness in the 5th and 5.5 th month, which suggested a delayed viremia. But what happened to the virus in the body in the first 5 months remained unaddressed.

2) According to M.P. Bush and S.H. Kleinman , primary infection can be divided into four stages of viremia , e.g. pre-ramp up, –ramp-up (exponential increase), –plateau phase, –post-seroconversion phase.The first stage is the eclipse phase of seed virus dissemination, which typically lasts 10 days but may be as long as several months(!). In this phase, neither rna-pcr nor antibody test shows positive. The delayed seroconversion appears to be due to a prolonged eclipse phase with delayed virus dissemination, and the development of viremia is always associated with rapid, subsequent seroconversion.

Because of these literatures, I just feel weak to persuade the worried wells to accept that the six-month test result is conclusive.

Who can tell? (Please post these questions to a hiv scientist you know and get the answer)

1. the existence of prolonged window period, or the delayed viremia.
2. what contribute to the delayed viremia, the gene factors of host and virus, or the amount of virus people are exposed to?

By the way,

3. Many worried well worried about a massage or a hand job without obvious blood and sex secretion. They become compulsive that they must exposed to HIV, though the amount of the virus is extremely small. Their question is what judgment should be made on these "low level exposure", no infection or infection with delayed seroconversion.

4. Since rabies virus has a very long inoculation time before systemic infection, what about HIV?

5. As we know that HIV infection is a vigorous process. Does this suggest that either the infection is etablished soon, or the virus will be eliminate in a not long time by some mechanism ?

I need your answers and arguments based on your research

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