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DUDE
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Expert
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Reged: 06/13/00
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Posts: 114
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Check this out, anyone want to interpret?
#6163 - 06/24/00 10:37 PM
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Hey, I pulled this off of http://hopkins-aids.edu/frames/index_booktoc.html.
What a great source, I pulled this paragraph out.
The window period: The time delay from infection to positive serology (EIA and WB)
averages 21 days with newer test reagents (CID 1997;25:101). Rare cases with windows
>6 months have been reported (Am J Med 1997;102:117). Prophylaxis with antiretroviral
agents and acute hepatitis C infection may prolong the time to seroconversion.
Seroconversion: Some patients serorevert in late stage disease, presumably due to
collapse of the immune system (JAMA 1993;269:2786; Ann Intern Med 1988;108:785).
Seroreversion may also occur in patients who achieve prolonged immune reconstitution
due to HAART (NEJM 1999;340:1683).
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I found this part more interesting:
False negative results: The frequency of false negative results is determined largely by the probability of testing in the "window period." For a population with high rates of seroconversion, such as injection drug users in Baltimore, who have seroconversion rates of 3-4%/year, false negative serology results occur in 0.3% (JID 1993;168:327). For a low seroprevalence group such as blood donors, false negative results are much less common (0.001%) (NEJM 1991;325:1; NEJM 1991;325:593).
Now, a crude interpretation of this is that if you were
exposed in a given year and tested in that year, then
there was a 1/10 chance of a false negative (0.3/3).
This would imply, from a crude calculation, that the window
period in IDUs is on average 365/10 days, or 36.5 days.
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I think this article is good news. It's more confirmation that 50% of people who are truly infected with HIV will seroconvert in about 3-4 weeks. They don't mention that the vast majority of people will seroconvert in 12 weeks, but I have seen it in other places on the Hopkins site. Finally, they mention that it is VERY RARE for someone to seroconvert after 6 months, and when this has happened, it has been linked to co-infection with HCV and taking PEP immediately after exposure. In other words, for almost all of us on this board, don't worry about late seroconversion!
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DUDE, stop trying to scare Mr. liver...
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