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Factors for Delayed Seroconversion for HIV
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Factors for Delayed Seroconversion for HIV

My question is this, and I've research far and wide for the answer.  I hear that among needlstick injuries, the average time to seroconvert is longer than sexual transmission.  What do you think is the cause of this.  Would it have something to do with the virus being in a weakened state in the needle and thus take more time to reproduce once in the host?  Or is my theory ogwosh? But what are your thoughts on this?
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To the best of my knowledge, that's wrong.  The time to HIV seroconversion is not correlated signficantly with the route of exposure.

HHH, MD
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So given your answer, what do you think of the reason why in 1990 a healthcare worker took 11 months to seroconvert.  Some speculate co-infection, some speculate other things.  Any opinion?  Also, how long does a drop of hiv infected semen surive outside the body?
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239123_tn?1267651214
I have no explanation for that particular case.  There are no absolutes in biology and medicine, i.e. exceptions to almost every principle.  I know of no reason to attribute that case's delayed seroconversion to the route of exposure.

It doesn't matter how long a virus (HIV, HPV, HSV, HBV) survives in secretions outside the body, e.g. on a toilet seat or a towel.  All of them can survive days or weeks.  But that doesn't mean transmission occurs by exposure to such secretions; it doesn't.

HHH, MD
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I should clarify that last statement.  When it comes to injection equipment, it probably does matter.  It is likely that a contaminated needle would be able to transmit HIV even after substantial delay, although the risk would decline over time.

HHH, MD
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This is going to seem like a strange question, but if you have another virus, could that delay seroconversion?  A few years ago I was diagnosed with Epstein-Barre, and so my immune system is not 100% most of the time.  In February is was at a concert, and one of the musicians had a tooth infection.  Don't laugh, but he kissed me before he left (deep kissing) and after he left I tasted blood in my mouth, I would assume due to the infection in his tooth.  I had accidentally bitten the side of my mouth earlier in the night.  I didn't know how to get in contact with the guy, so I went to the health department for an HIV test at 6 and 13 weeks.  The woman testing me looked at me like I was nuts for getting tested, but even though it was just kissing, there may have been blood contact.  I tested negative both at 6 and at 13 weeks, which I know you have said is pretty indicative of overall negative HIV status.  The woman of course gave the "you should test again at 6 months to make sure because it could take that long to show up."  Now my question, after all of that - would a compromised immune system delay seroconversion?  I mean, would it take longer for the body to start creating the antibodies to show up on HIV tests?  Over the few months I waited I had several "viral" symptoms - sore throat, sore on gums, loss of appetite, some sore muscles, not all at the same time, more spread out over the three months.  I may just be paranoid, but I was just wondering if the weaker your immune system is, the longer it takes to test positive?  Do you feel I should worry enough to test again at 6 months or take the 3 month negative for what it is?  Sorry to post on somebody else's question...
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239123_tn?1267651214
Contrary to popular belief, past or chronic Epstein Barr virus (EBV) infection do not cause important immune system abnormalities that increas susceptibility to other infections, or that would modify the response to HIV or cause an HIV test to be falsely negative.  You can rely on the negative HIV test at 3 months.  But as I have said many times on this board, many people are likely to be more reassured by yet another negative test result than by my words.  So if you'll sleep better following a negative test at 6 months, go for it.

HHH, MD
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A related discussion, window period was started.
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A related discussion, Epstein Barr vs Hiv coinfection was started.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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