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PaulB
Unregistered

Some Info on ARS, Seroconversion and the Rest
      #27994 - 02/08/02 06:10 PM

To Everyone Worried about ARS and Seroconversion
------------------------------------------------

Technically ARS and seroconversion are not the same thing.

ARS = Acute Retroviral Syndrome, sometimes called Acute Viral Syndrome, or Primary Vital Syndrome is a set of symptoms (syndrome) that occurs 2-4 weeks after the exposure to the HIV retrovirus (hence the term retroviral), PROVIDED THAT YOU ARE INFECTED. Chances are that you are not. 2-4 weeks is not a magic interval. Sometimes (very rarely) ARS begins up to 6 weeks after the infection, sometimes it begins a bit sooner. It is estimated that up to 80% of people (90% according to another source) that are infected with HIV do get ARS. However, the remaining 10% or 20% do not, and they proceed to the prolonged asymptomatic stage, when there are no
symptoms at all. The term acute is the opposite of chronic. It means that the symptoms usually come together, are quite serious, and do not last very long. Usually a few days, up to 1, maybe 2 weeks. It has been emphasized that ARS is NOT a chronic condition, and if you are having symptoms week after week, you probably do not have ARS.

Now about the symptoms. Typically they resemble a BAD flu. They may, however, be mild, or, as I said, non-existent. However, in general they are quite severe and in 30% of cases they are so severe that people go to their doctors.

Fever is the most common symptom. It occurs in 91-96% of all cases. The other symptoms, and the percentage of people with ARS that DO get them are given below:

Fever (91.4%) - 38 oC - 41 oC or above!
Fatigue (84.3%)
Skin rash (75.5%)
Headache (68.6%)
Myalgia (67.1%) - that's muscle pain

These are the most common symptoms that occur in more than 50% of those that get ARS. The following are the less common symptoms. They occur in less than 50% of those that get ARS.

Arthralgia (41.4%) - that's joint pain
Pharyngitis (40.0%) - sounds mysterious, means sore throat
Oral ulcer (40.0%) - herpetic/aphthous lesion in the mouth
Weight loss (34.3%) - over 10 pounds in 1 week
Odynophagia (34.3%) - lack of saliva production, dry mouth, speech becomes thick and indistinct
Anorexia (27.1%) - lack of appetite
Diarrhoea (27.1%) - this refers to prolonged diarrhoea, for several days
Nausea (25.7%)
Oral candidiasis (22.9%) - a disease of the mouth

This data has been taken from
http://www.retroconference.org/2001/posters/414.pdf
and is fairly reliable.

According to Dr. Reznick, one of the experts on TheBody, the oral symptoms (i.e. the ones that occur in the mouth) are not considered part of the ARS because they occur fairly rairly, and cannot be linked to it statistically.

Sometimes neurologic symptoms occur. I shall quote Dr. Keith Henry, I hope he doesn't mind. The most common neurologic symptoms of ARS are:

"Muscle or joint pain in about 50%, encephalopathy (brain involvement with headache and other CNS findings often mimicing aseptic menigitis) in around 8%, peripheral neuropathy 8%."

Peripheral neuropathy is a tingling sensation, pins and needles, that is very, very often quite painful. According to Dr. Judith Feinberg, it affects the longest nerves first, therefore it always starts in the toes, may progress upwards to involve the legs and may also involve the fingers. Peripheral means that it occurs in the lymbs. In general it is symmetric and affects both parts of the body equally. Let me remind you that it occurs in only about 8% of those undergoing ARS.

Swollen lymph nodes, same as swollen lymph glands, (lymphadenopathy) are indeed common in this case.
If you are a Worried Well case, like myself, which you probably are, let me mention a few things. These symptoms are fairly non-specific and do not necessarily indicate that you have HIV. Also, the absence of symptoms does not necessarily indicate that you do not have it. However, according to the National AIDS Helpline (UK) up to 80% of people that get HIV DO have some of these symptoms. The symptoms are very similar to those of a bad flu (influenza) or infectious mononucleosis (mono). If the symptoms come in succession and last a very long period of time, you probably have paranoia, OCD, and/or anxiety, like myself (I have just been diagnosed with these, so I am officially insane, but you can still trust me! ;-) rather than HIV. If you keep on paying attention to whatever is awry in your body, and link everything to HIV, you definitely have hypochondria, another lovely mental condition. If your exposure is very low risk (like mine), and you think you are going to be the one that did get HIV, if you think that you are going to proceed to AIDS faster than everyone else if you have HIV, if you think that you are the rare case with the weirdest ARS symptoms that one can imagine, you are a confirmed Worried Well. Worried Wells spend most of their time browsing the net in search of HIV-related information and/or keep on reading miscellaneous medical books on AIDS/HIV.

Please don't attribute everything that is going on in your body to ARS. It is winter and many people around are garanteed to catch at least one or two flu's and/or colds with fever, etc. If you are anxious, you will most definitely develop odynophagia (dry mouth), and anorexia (lack of appetite), and whatever symptoms you can imagine. If you work, you are most likely to be fatigued. Muscle pains and joint pains are hardly uncommon. Dry mouth will most definitely be present if you live in a room with dry air. I can continue indefinitely.

Swollen glands are a common sign of ARS. It is also a common sign of any other infection that you can imagine. They occur in response to colds and flu's, coldsores caused by herpes simplex virus, sometimes acne, cuts and wounds, etc., whenever there is any kind of inflammation. In some HIV-negative people they disappear in a matter of weaks, sometimes months. Some healthy people have their lymph nodes swollen for long, long periods of time, months, even years. HIV may cause different forms of lymphadenopathy, but the most usual form is diffuse generalized lymphadenopathy. This means that swollen lymph nodes occur in at least two regions of the body (commonly on the neck and in the armpits) excluding the inguinal area (that's where humans have their most useful and interesting organs).

Swollen lymph nodes tend to be quite big and easily palpable, at least 1 cm in diameter, frequently much larger. When they are not swollen, they may be palpable as well, but are generally smaller, less than 0.5 cm in diameter. The term "tender" applied to lymph nodes usually implies somewhat painful.

Let me emphasize something. You CAN'T diagnose yourself with lymphadenopathy. That's something for your doctor or an experienced nurse. I used to think that I had swollen lymph nodes in all imaginable places. However, my GP and my nurse have explained to me that I didn't have any! Lymph nodes are easily confused with muscles, etc. In fact I do tend to get a small lymph node on my neck in response to any kind of inflammation. My GP sais that it's a so-called reactive lymph nodes and is a very, very common phenomenon.

Self-diagnosis is a dangerous thing. I diagnosed myself with thrombocytopenia on the basis of "small red dots" on my palms which, I thought, were thrombocytopenic petechiae. I assumed I also had signs of "easy bruising". All these symptoms occur when someone has a low platelet count, typically around 30-50 x 10^9/L. Thrombocytopenia (lack of platelets) is a rare complication of HIV, and may occur with many other conditions. Well, according to my CBC (complete blood count) I have 284 x 10^9/L platelets in my blood (the normal interval is 136 - 343 x 10^9/L), which means my self-diagnosis was "a bit" wrong.

Also I would not recomment you to cry over things like loss of hair, etc., which have nothing to do with HIV. Don't think that you are progressing faster than anyone else (if you are INDEED infected) and don't think that you will develop symptoms of full-blown AIDS right after the exposure. On average it takes around 15 years to get there WITHOUT treatment, AND YOU WON'T BE THE ONE TO GET THESE SYMPTOMS RIGHT NOW. For instance, people (like myself) do start worrying about eye floaters. I have them right now. They have probably read that eye floaters occur in HIV+ people. It is true, they occur in people with ADVANCED DISEASE when the person develops severe eye problems. That's when this symptom is meaningful. However, many HIV- people have them too, I have them myself since early childhood. Although I am not sure they are eye floaters.

After ARS most people will progress to asymptomatic stage of the disease (i.e. the person is HIV+ but has no symptoms at all). However, some people progress to the next stage, involving generalised lymphadenopathy, which is often the only clinical symptom. In general it takes 10-15 years to develop HIV without treatment. The current treatment against HIV is very good although it doesn't work for every single person (sometimes there is resistance) and is quite often associated with severe side effects. It does not cure but can control the disease increasing the quality of life of HIV sufferers and, according to optimistic researchers, it allows them, in good cases, to have a fairly normal lifespan. However, it is different for each individual and depends on his/her organism, treatment, etc. Many people in the developing world do not have access to the most primitive health care, not to mention the expensive HAART treatment.

Now let me explain what the term seroconversion means. It is not the same as ARS. Seroconversion occurs after infection with HIV. It is the process when the blood of the infected person (or in fact his/her serum) is converted (hence the term) by developing antibodies against HIV. In general antibodies are generated by the person's immune system and are meant to fight the infection. Only, very unfortunately, HIV antibodies can't kill the virus and cure the HIV-positive person. Otherwise our planet would be free of this cursed disease. Seroconversion makes it possible to detect the anti-HIV antibodies in the blood, the basis of most HIV tests. So these tests will only work AFTER the seroconversion has taken place. Usually it takes people several weeks after the exposure to seroconvert and develop the sufficient concentration of antibodies in the blood for the tests to be able to detect the virus. The period when testing is not considered meaningful because, if the person IS infected, the amount of antibodies in the blood is too low to be detected, is called the window period. The only way to tell for sure whether you have HIV is not by looking at the symptoms. It is by testing at the end of the window period. Here, in UK, the window period is considered to be 3 months after the exposure. After these 3 months the tests become about 99% accurate (which is about as accurate as medicine can get). Although rarely, false positive and false negative results do occur, this is why they usually do confirmatory tests. In VERY VERY RARE cases seroconversion takes longer.

I know it may be difficult (and scary) to do an HIV test, although it is the only accurate way to determine whether the person is infected or not. CBC (complete blood count) may contain some clues as to whether or not the person has HIV. However, this is not a diagnostic test. According to Dr. Judith Feinberg,

"The CBC holds clues to the possibility of HIV infection, but none are absolutely diagnostic. HIV+ people usually have leukopenia, with both neutropenia and lymphopenia. Often they are anemic, and a small proportion have thrombocytopenia. Unfortunately these same abnormalities can be seen in many other conditions."

I honestly hope you are well, and healthy. HIV is not as easy to get as most people think, but CERTAINLY not impossible. Check the section "How is HIV transmitted" at

http://beatnikboy.tripod.com/

Some activities carry a theoretical risk of transmission (i.e. medics and biologists can describe how this transmission might happen), although in practice this happens EXTREMELY rarely, or "never" at all (well, you never know for sure, but there haven't been any documented cases). E.g. there are only two well-documented cases of transmission of HIV to the person performing cunnilingus on a woman. In each case the procedure was rather traumatic.

Unprotected receptive anal sex is the riskiest of all and the chance that the receptive partner will get HIV given that the insertive partner is HIV positive is about 20%-30%, i.e. highly likely.

I hope you will be well and healthy. Play safe and don't put yourself and those you love at risk.

I hope this helps.

Yours sincerely,
PB





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Anonymous
Unregistered

Re: Some Info on ARS, Seroconversion and the Rest new
      #27997 - 02/08/02 06:21 PM

Thanks for the summary. What has confused me is that there is much contradictory info on many sites through out the web. Even on this site, there have been statements by someof the experts that Thrush is a symptom of ARS..in fact...in your facts prior it said 22% of the time.

Then I have read Rick S's stuff , REznik & others that say thrush does not occur with ARS, 99999% of the time mid to lage stages of HIV. What is it?

thanks



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PaulB
Unregistered

Re: Some Info on ARS, Seroconversion and the Rest new
      #28003 - 02/08/02 07:04 PM

I absolutely agree with you. There is a lot of contradictory information. I believe this is due to the fact that medical data is quite difficult to assess and convert into numbers. Also, several independent studies may come up with somewhat different results. In the age of information what we really need is co-ordination. When I was writing this summary I relied on what I considered the most trustworthy results. As to thrush, according to most sources, it is quite unlikely to occur early in the course of infection. The immune system must be severely compromised. So it's most likely to occur later on. It does however occur in people that use antibiotics.



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Richard
Unregistered

Re: Some Info on ARS, Seroconversion and the Rest new
      #28004 - 02/08/02 07:20 PM

Dear Paul,

You have done some great research, and it is very good to have that knowledge at this particular period of your life. But we all have to know (probably me first - as I don;t beleive in anything atthe moment) that symptoms mimic lot of other illnesess and if you look on the net something else you will find that almost 80% of symptoms are related to hundreds of different illnesses.

That is the main reason that doctors refuse to make a diagnose based on symptoms, not only with HIV but anything else. It is also due to fact that different people feel differently about the same type of pain or symptom, and further to that they explain differently.

And how many times I went to doctor and forgot to tell him about this or that, and than went back again and than forot to tell about something else.

So, no sickness of any (half) serious nature can be done with symptoms to the best specialists in the world. That is why there are so many tests, scans, biopcies etc - for confirmation what it is.

In lot of instances we are talking about risks too. High, low, medium, percentage etc etc. We also do know that lot of couple hetero, gays, lesbians etc live together one HIV+ one not and they don't get infected with numerous unprotected sex encounters. Than someone gets it after first exposure because condom broke. We will never know and doctors don;t know enough - there was not enough studies to know more precise - that is why they suggest to do the test.




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Oh no, not again
Unregistered

Re: Some Info on ARS, Seroconversion and the Rest new
      #28009 - 02/08/02 08:42 PM

Richard, thank you for correctly noting that the symptoms are not specific to HIV. Plenty of viruses cause an acute illness, thats why its called "acute retroviral syndrome" and not "acute hiv syndrome". Plus there are many other non-viral illnesses that look like ARS, like food poisoning for example.

But the worried wells don't usually just have a brief bout with an ARS-like illness. No, because that actually would be a valid cause for concern. Instead, they usually have ongoing, chronic complaints of weird symptoms that have no relation to HIV. They always say its not in their heads, which I'm sure it isn't, because if you're going to imagine symptoms, why not imagine the symptoms that actually match ARS? They insist that their symtoms are "real" but they don't seem to realize that, real or not, the symptoms don't match HIV in any way. My favorite so far is the guy whose pubic hair is falling out. ROFLMAO!!! Is a bald pubis related to HIV? LMAO!

Also, since some people become HIV+ with no ARS illness at all, even if you have no symptoms, or completely unrelated symptoms, you can't tell if you have HIV without a test. But some worried wells don't believe their negative tests either. According to them, the virus mutates so fast that it easily escapes detection by all tests. So there you have it, their symptoms absoultely MUST be HIV. There is no other possible explanation.



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PaulB
Unregistered

Re: Some Info on ARS, Seroconversion and the Rest new
      #28010 - 02/08/02 08:51 PM

Hi Richard!

I certainly agree with you. I have already described how I misdiagnosed myself and decided that I have swollen lymph nodes.

Certainly you cannot determine whether somebody has ARS based on the symptoms, although they do give a rough idea.

And you are certainly true about the risk. Statistics is often misleading, and you cannot use it to determine whether a person will be infected or not. However, I think that it gives you a rough idea of what has happened.

What worries me now is this. The symptoms that I am having do not seem to follow any descriptions of ARS. I was told by some people that they have nothing to do with ARS. However, I am extremely worried about the symptoms, because they are very strange, and I have never had anything like this before. Could you please tell me, could I be an atypical person, with atypical ARS symptoms? Or perhaps I have developed some neurological complication? In fact my exposure was low risk (again, that's relative), and I cannot find any explanation. (Perhaps you have read my post - I have tremors and twitching throughout the body most of the time, and rumbling stomach.)

Yours sincerely,
Richard



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OBSESSING!!
Unregistered

Re: Some Info on ARS, Seroconversion and the Rest new
      #28011 - 02/08/02 08:55 PM

This is a VERY good posting. Thnak you. I wish I could get over my thinking my current "flu" is HIV/AIDS
( horseness, nightsweats, low grade fever, sore throat, earache, dry hacking cough). I even totally freaked out yesterday and went to the Emergency room to be looked at by a doctor after my own GP said there was no need to come in. So, I am doubly ashamed that I wasted the time of the E-Rooms docs to find out I have a "upper respitory viral infection". Is this AIDS??????? I have only ever had protected vaginal sex and 4 times I have performed oral
( unprotected) on a woman.

My whole life has been taken over by my OCD.



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PaulB
Unregistered

Re: Some Info on ARS, Seroconversion and the Rest new
      #28012 - 02/08/02 09:11 PM

It's probably something to be ashamed of, but you are not the only one that has wasted time in Emergency Room... :)



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anxietyboy
Fanatic

Reged: 01/07/02
Posts: 57
Great post! but some inaccuracies new
      #28017 - 02/08/02 11:34 PM

Excellent post but your last stat about unprotected receptive anal intercourse is incorrect. From the CDC website:

"The risk of getting HIV from an infected person during one episode of anal sex is between less than 1% and 3%, and the risk during vaginal intercourse is less than 1%. Instances of HIV transmission during oral sex have been reported, but no exact estimates have been published. The risk is much lower than during unprotected anal or vaginal sex."

We don't want inaccurate info to freak anyone out...



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Richard
Unregistered

Re: Some Info on ARS, Seroconversion and the Rest new
      #28020 - 02/09/02 12:49 AM

If people start to feel unwell and if that last for bit longer they should go and visit the doctor. Whether that is HIV related, anxiaty or something else.

I am going through simillar thing myself so I know how most people feel no matter what anybody say. The symptoms whether they are related to illness or anxiaty are real. They are there and you feel them. Of course reading about something and developing fear - it just add to the basket of symptoms.

There is tremedous guilt associated with HIV, not just being the way it has been transmeted - but also the way it has been percived in the life.

A HIV specialist told me that lot of people who do come to start testing and are worried about it are saying they would rather have cancer than HIV.

So, whether that people are worried well, or have some reason to fear HIV, they desperately need help, not accusation, and at least not non-understanding.

I am seing mental therapist over this and it is great help. With worried well might find not being HIV, but loose mental health and needs months to recover. Lickily this is at least treatable easy - but it will take time to get back to normal.



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PaulB
Unregistered

Re: Great post! but some inaccuracies new
      #28028 - 02/09/02 08:33 AM

I have checked it. I think your information is more accurate. Contradictory sources perhaps...



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OBSESSING!!
Unregistered

Re: Great post! but some inaccuracies new
      #28034 - 02/09/02 11:33 AM

Does the percentage for vaginal sex apply to the inserter or receiver? Would it not be much lower odds for the inserter?



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PaulB
Unregistered

Re: Great post! but some inaccuracies new
      #28036 - 02/09/02 12:12 PM

I am not sure what the estimated numbers are, but the risk for the one that "inserts" in vaginal sex is considerably less than the one that "receives". This is partly due to the fact that the concentration of the virus is much higher in the sperm than it is in vaginal secretion. In addition, if the male ejaculates into a female, and he is HIV+, the female receives a considerable amount of fluid. The concentration of the virus, the duration of contact with the fluid, and the amount of the fluid on the mucous membrane determine the likelihood of transmission.



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Anonymous
Unregistered

Re: Some Info on ARS, Seroconversion and the Rest new
      #98168 - 05/08/04 10:06 PM

Oh my god. You've so described me in this post. I've been living in hell this past week surfing the net for HIV/AIDS info. Like you, I could teach a 3 credit hour course just on seroconversion, timing, symptons, pathology yada yada.
I'm finally feeling better having gotten over my paranoia.
All the best to everyone.


But what if...



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Anonymous
Unregistered

Re: Some Info on ARS, Seroconversion and the Rest new
      #99184 - 05/26/04 09:36 AM

PaulB.
yours is a message of hope.
but even with that I am terribly scared.
and i feel so stupid.
I am really realizing how things I never thought of are the most important.
I am hoping.
49 days more.


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