Facts About HIV Seroconversion

What It Means to Be HIV-Positive or HIV-Negative

HIV blood test
David Silverman/Getty Images

Seroconversion is the time in which a person develops antibodies to any disease-causing microorganisms (called pathogens). Antibodies are the defensive proteins produced by the immune system to neutralize a pathogen and is specific to that pathogen and that pathogen alone.

When blood tests are able to detect these antibodies, a person is said to have seroconverted.

Understanding HIV Seroconversion

In the case of HIV, seroconversion means that a person has gone from being HIV-negative (having no HIV antibodies) to being HIV-positive (having HIV antibodies).

Seroconversion is confirmed by an HIV antibody test. It usually takes a few weeks for the body to produce enough antibodies for the test to confirm an HIV-positive diagnosis. Prior to this, the test may either be inconclusive or deliver a false-negative result. This period of uncertainty is known as the window period.

Once a person has seroconverted, he or she will always be HIV-positive for life. Even if the person is placed on HIV therapy and is able to achieve an undetectable viral load, the virus never fully disappears. "Undetectable" simply means that the amount of virus is the blood is so low that currently available blood tests are unable to detect them.

Symptoms of HIV Seroconversion

A person who has seroconverted may or may not have symptoms of infection. Symptomatic infection is typically referred to as either seroconversion illness, acute seroconversion, acute HIV syndrome, or acute retroviral syndrome (ARS).

ARS occurs in anywhere from 50 percent to 70 percent of newly infected individuals. The symptoms of ARS are similar to those of flu or infectious mononucleosis and may include:

  • Fever
  • Fatigue
  • Headache
  • Sore throat
  • Muscle pain
  • Joint pain
  • Swollen lymph glands

Because the symptoms are so non-specific, they are often attributed to other illnesses.

One of the more telling symptoms of ARS is a characteristic rash. The outbreak will tend to affect the upper half the body with lesions that are reddish, small, flat, and non-itchy. As with the other ARS symptoms, they can appear anywhere from one to four weeks after infection and usually resolve within one to three weeks.

Early Diagnosis

There is evidence that the diagnosis and treatment of HIV during acute infection may significantly slow the progression of the disease. By hitting the virus with treatment in the early weeks, some believe that the virus has less opportunity to establish hidden sanctuaries in tissues and cells known as latent reservoirs. Once HIV is embedded in these reservoirs, they are almost impossible to clear from the body.

To this end, newer-generation combination HIV tests are able to deliver accurate results in as little as 12 days compared to previous generation tests which took at least three weeks. These combination assays are able to do this because they detect both HIV antibodies and HIV antigens (proteins found on the shell of the virus itself).

When compared to plain antibody tests, combination assays like the ARCHITECT HIV Ag/Ab are able to detect over 90 percent of acute HIV infections.Older tests were only to catch about a third.

Sources:

Cohen, M.; Gay, C.; Busch, P.; and Hecht, F. "The Detection of Acute HIV Infection." The Journal of Infectious Diseases.2010; 202(Suppl 2): S270-S277.

Pilcher, D.; Louie, B; Facente, S. et al. "Performance of Rapid Point-of-Care and Laboratory Tests for Acute and Established HIV Infection in San Francisco." PLOS|One. December 12, 2013; DOI: 10.1371/journal.pone.0080629.

Continue Reading