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HIV Transmission and Education >> Am I Infected?

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Anonymous
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late sero's
      #26787 - 01/09/02 08:37 PM

Has anyone seen any studies that give evidence as to why people take longer then 6 months to seroconvert ?and could u link this study. I tested negative at 6 months but still expierencing wierd symptoms. I want to put this behind me but still kind of worried. Thank



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Anonymous
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Re: late sero's new
      #26789 - 01/09/02 10:10 PM

Good question. I have looked high and low, but cannot find very much on late seroconversion.

The only real documented cases of late seroconversion that I know of are cases of health care workers, because they are the only ones studied. With everyone else, it is only their word about exposure, so I suppose that they are not really considered to be truly documented. So it makes sense that all available case studies of late seroconversion are health care workers. Naturally, the next theory would be that they took PEP and that delayed their seroconversion, but I have not even seen that confirmed for sure.

We do know for sure that the older antibody tests were not as sensitive as today's tests are. And there was a time when they did not have the P24 antigen test, or PCR to detect hiv viral load. So if a case of late seroconversion is old enough, these could be contributing factors.

But many of us never get P24 or PCR testing, so we are hoping that the current antibody test is sensitive enough. I read somewhere that todays antibody tests are almost as sensitive to antibodies as the PCR test is to virus. This is very sensitive, so that's good news.

But the problem with antibody testing is that the body must produce some antibodies in order for them to be detected. This opens the question of how long hiv could hide in the body before the immune system recognizes it and forms antibodies. Much of the available information claims that normally after infection, hiv will quickly multiply to very high levels in the body, and then antibodies form shortly after that. This is the norm, and so most people test positive within the first month or so after infection.

But what about those who take longer than 3 months, maybe even longer than 6 months? It is a mystery that the doctors don't seem to be studying very much. What if innoculum size affects it? That's what I am afraid of, since my only exposure was to pre-seminal fluid. What if it takes more than 6 months for this tiny amount of virus to multiply to a level that my body recognizes? And if this is the case, does it affect the long term prognosis? Also, is the body capable of eradicating such a small amount of HIV early enough during infection that the virus dies off, and antibodies never form? If so, then the person would be HIV negative for all intents and purposes. But is this possible?

I sure wish we had some answers. I will be sure to post my story here if I am one of the late seroconverters. Maybe some kind doctor will decide to study it.



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Anonymous
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Re: late sero's new
      #26793 - 01/10/02 01:20 AM

haha, I too think im gonna be that rare case that sero's after 6 months and im going to be studied. It just seems like they dont know a lot about HIV testing and serology to give people like me comfort. I worry more now because im interested in someone and im scared that even after my 6 month negative i might infect her. I wish they would put more of an effort on studying the window period and hiv tests so we wouldent have to worry like this.



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KitG
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Reged: 01/15/01
Posts: 103
Re: late sero's new
      #26814 - 01/10/02 12:22 PM

I don't think there's any mystery about why doctors aren't studying late seroconversion further, because quite simply, there's nothing more to study, at least not from the point of view of HIV infection! After all, from the point of view of natural history and progression, we're talking about one of the most intensively studied diseases ever. If they felt there WAS a need to, they would. When HIV doctors are happy there's no infection, then quite rightly, they assume their work to be done. If they feel it necessary, they might refer on to specialists in other areas, maybe even mental health professionals, which is sometimes difficult for people to accept when they are experiencing physical symptoms, which they might feel are not being taken seriously, or the implication they are "mentally ill", with all the preconceptions and stigmatisation issues that might hold for the person. But I suppose that's how the medical world works.

Personally, I think there could be a useful study about why some people seem to experience symptoms for so long, but this would be more to do with the effects of extreme, chronic stress and worry upon the body, and upon the person's experience of and focussing upon their body so intensely, if you see what I mean. Because I do think this sort of experience contains so many issues, which could be relevant on a larger scale.

As regards late seroconversions, as far as I can remember, there's one documented case of a healthcare worker seroconverting late, after about nine months or so I think, and this was a good few years ago, using older, less sensitive tests. On the other hand, there's masses of documented cases of people for whom symptoms persist after a six month negative test, leading them to keep worrying about "what if". But again, there's no documented cases I've heard about where any of these people actually prove ultimately to be HIV+. Certainly none on this Board, and there have been lots who have worried for this long. Nor from any of the doctors on the Expert boards who been asked the very same question.

From what I experienced, and from those I've talked to here who went through a similar thing, I think the key is to move to find a way to a level of acceptance and trust in what you have been told by your tests, and by doctors' clinical judgement if they've seen you and examined you. I was seen and examined by three different HIV doctors at 1.5, 3 and 4.5 months, by which time they were telling me 100% I was not infected (none of this >99.9% probability or whatever. Probably because they were seeing me face-to-face, rather than answering my questions on the phone or over the internet, they were able to be so definite ). But the ongoing symptoms, plus all the fears I had after reading about "late seroconversion", and the "layman's" theories I was coming up with about why I might be different, all these things meant that even after my six month negative, I was still worried (which was when and why I turned up here for the first time!). And looking back now, I can see that all that the further worry did was to keep the vicious circle of more symptoms and more worry going for a good while longer still.

Your weird symptoms may continue and it may be that you'll never get a definitive answer about what's causing them. But when you get to the post six month stage, I really think you can and must try and accept the results and the doctors' judgements. It's not easy when you reach this stage and it's hard to write down exactly how to do it, but for me anyway, it was the only way I was able to find peace.



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