The Stages of HIV Disease
August 22, 2008
Some individuals who fear they have recently been exposed to HIV may be curious about PCR and RNA viral load testing, which test directly for the virus itself rather than for antibodies and can therefore be used during the acute infection stage. Viral load testing is generally used by physicians to track the progression of HIV disease in the body -- thus helping HIV positive patients make choices about appropriate treatment strategies. Most people concerned about their HIV status do not need viral load testing. The antibody test is the cheapest, easiest, and overall most reliable way for individuals to learn their HIV status. That said, individuals who have been exposed to HIV recently and experience symptoms consistent with acute HIV infection can request a viral load test from their doctor. This test may help identify HIV infection during the "window period" before HIV antibodies have developed, though an antibody test will ultimately be needed to confirm the viral load test result.
Some doctors are treating newly infected people (those in the acute stage of HIV infection) with a combination of anti-HIV drugs. Scientists disagree about whether anti-HIV treatment is useful during primary HIV infection. While some researchers are optimistic about the impact of very early anti-HIV treatment, they are also concerned about drug side effects, long-term effects on the body, and the possibility of developing drug-resistant virus if people use powerful anti-HIV drugs before they become ill due to HIV disease. You should consult with your doctor to make the most informed choice about when to start taking anti-HIV medications.
This term refers to the time when an HIV positive person's immune system responds to the infection by producing antibodies to the virus. Most people develop antibodies within three months after infection, and some can take up to six months.
If an antibody test is done before seroconversion is complete, it may give a "false negative" result because sufficient antibodies have not yet been developed by the body. A three-month window period between infection and production of antibodies is normal for most of the population. Very, very rarely (i.e., in only a few cases ever), a person may take six months to produce antibodies. To be certain of your HIV status, take an HIV antibody test three months or longer after you were exposed to the virus. For even greater certainty, get tested again six months after the exposure occurred.
After the acute stage of HIV infection, people infected with HIV continue to look and feel completely well for long periods, usually for many years. During this time, the only indication that you are infected with HIV is that you will test positive on standard (antibody) HIV tests and you may have swollen lymph glands.
This means that you look and feel healthy but can infect other people through unprotected sex or through needle sharing -- especially if you have not been tested and do not know that you are infected.
Even though an infected person may appear perfectly healthy, HIV is still very active and is continuing to weaken the immune system during this stage. In some individuals, the virus appears to slowly damage the immune system over a number of years. In most people, however, a faster decline of the immune system occurs at some point, and the virus rapidly replicates. This damage can be seen in blood tests before any actual symptoms are experienced.
HIV positive people should seek medical care and begin monitoring their immune systems as soon as possible after receiving a positive test result. Periodic immune monitoring tests, such as CD4 count and viral load tests, can give you and your doctor a better picture of your immune health and disease progression, and can help you make smart choices about treatment.
Seeking early care for HIV disease can give people better chances of survival and improved quality of life. People with HIV are encouraged to see a doctor regularly, even if they feel fine at the moment, because the virus could be already damaging the immune system. Early and regular care enables HIV positive individuals and their medical care providers to take control of their treatment before symptoms appear.
This article was provided by San Francisco AIDS Foundation. It is a part of the publication AIDS 101. Visit San Francisco AIDS Foundation's Web site to find out more about their activities, publications and services.