Global Statistics on HIV/AIDS released by UNAIDS reveal that in 2020, there were approximately 37.7 million people worldwide with HIV. Indeed, HIV is one of the most severe diseases in the world today. Despite the advanced methods of testing, this virus cannot be detected immediately after it is contracted.
For timely detection of HIV, one needs to understand the different stages of HIV Infection, one of which is seroconversion, an essential stage of HIV infections.
- But what is seroconversion?
- What are the signs of seroconversion? And why is it so important in HIV prevention?
Through this blog, we help you answer these questions by decoding the anatomy and the timeline of HIV with a particular focus on seroconversion time, its signs, and its importance.
What is HIV?
HIV is the abbreviated term for the human immunodeficiency virus. As the name suggests, the HIV virus affects your immune cells called CD4 T lymphocytes, causing the immune system to fail. Your body cannot fight off additional infections and diseases if these cells are not present.
Breast milk, vaginal fluids, anal fluids, and blood of an HIV-infected person contribute to the transmission of HIV infection. The disease can be transmitted to a person through:
- Unprotected anal sex
- Unprotected vaginal sex
- Use or sharing of needles, syringes, and other drug equipment
- Birth and Breastfeeding
The HIV infection works in several stages:
Transmission: The first stage of transmission is when a person is exposed to the HIV virus.
Acute HIV infection: Also known as acute retroviral syndrome. At this stage, the virus is spread into the body actively and regularly through infected cells that form a part of a reservoir created by the virus.
This stage marks the beginning of the disease, wherein
- the person will have a heavy virus load in their blood,
- the virus is contagious,
- may suffer from flu-like symptoms but
- may not feel sick.
HIV assaults immune system cells in the body and replicates itself using the cells’ own mechanism. Some of these cells go into a latent state while others actively replicate and spread the infection. The cells in the resting state do not produce new or more virus cells. However, these cells can stay hidden for a long time, sometimes even for years, and create a reservoir called a latent reservoir and have the tendency to become active in the future and spread the virus.
An essential part of the infection cycle, seroconversion is the period where the body’s defence mechanism gets activated and starts producing antibodies to fight against the infection. The antibodies help reduce the body’s viral load, which was very high before. The CD4-T cell count also rises, although it may not be as high as before. Seroconversion usually happens about 2-3 weeks after the infection, during which the person infected will have symptoms.
For accurate HIV diagnosis at labs, HHC offers a wide range of high-quality SEROCONVERSION PANELS to detect asymptomatic donors infected with HIV, HCV, HBV and EBV, as well as SURVEILLANCE PANELS and LONGITUDINAL PANELS. In addition, our range of SEROLOGICAL CONTROLS, the SeraCon Run Controls, are intended for use in assessing the performance of immunoassay test procedures for the qualitative determination of HBsAg, anti-HIV and anti-HCV.
Chronic HIV infection
At this stage, the infection persists, however, at lower levels. The person infected may or may not show symptoms, but they can pass the HIV to another person. Taking HIV medication during this period can help you avoid developing AIDS.
AIDS or Acquired Immunodeficiency Syndrome
This is the final and the most severe stage, as the virus has caused serious damage to the immune system of the patient. The HIV viral load increases, the CD4 cells count drops dramatically, and the patient becomes highly infectious. AIDS works as a catalyst for attracting other infections as the immune system is destroyed and can lead to death within 2-3 years if untreated.
What is seroconversion?
Seroconversion is the timeframe within which antibodies are produced in a patient’s blood after exposure to a viral infection. These antibodies are essential proteins that help fight against viruses, bacteria and other foreign bodies or germs. Seroconversion time is ideal for testing and detecting infections.
HIV Seroconversion refers mainly to the window period or the time frame between the exposure to the virus and the formation of antibodies, at which point, an antibody test can detect HIV. If the tests can detect the antibodies in the blood, the patient is known to be seroconverted. All tests done before this event may produce a false-negative result or be uncertain or indeterminate.
This period is also known as the window period. A seroconverted patient whose blood tests confirm the presence of HIV antibodies is HIV-positive and will be HIV-positive for the rest of his life.
What are the signs of seroconversion?
Shortly after the infection, when antibodies are produced, the patient may show symptoms of infection. Most people who are infected will show signs of Seroconversion illness. Seroconversion disease, acute seroconversion, acute HIV syndrome, or acute retroviral syndrome (ARS) are all terms used to describe the symptomatic infection.
In general, symptoms of seroconversion illness occur in about 80 to 90 per cent of the new cases. Seroconversion varies from person to person. In some cases, there is a likelihood that the person must be hospitalised. Some people may show minimal symptoms like the flu. The time between HIV exposure and seroconversion varies, although most persons test positive within a few weeks of infection. The most common signs of seroconversion illness are:
- Swollen lymph nodes
- Mouth sores
- Night sweats
- Sore throat
- Muscle aches
- Oral thrush
- Weight loss
- Joint pains
- Gastrointestinal symptoms, such as vomiting and diarrhoea
- Genital sores or thrush
- Nervous system involvement (meningitis or encephalitis).
These signs are common and can be attributed to many illnesses, so to determine the HIV infection, it is necessary to get tested after exposure. In most cases, the infection may not get detected if tested immediately after the exposure as the seroconversion has not kicked in.
Another more revealing symptom of ARS is a distinctive rash or lesion that may tend to appear on the upper body. These lesions may have slight redness; they will be small and flat but non-itchy. Lesions like these can occur any time within a month of the infection and usually go away within three weeks.
Diagnoses of HIV
HIV infections cannot be cured, especially once the seroconversion has begun. However, HIV can be controlled so that it does not develop into AIDS.
No specific tests are designed to test HIV immediately after exposure and before seroconversion.
Some standard tests recommended by doctors are:
Nucleic acid test (NAT): NAT is an efficient and rapid test for catching HIV infection. It can typically identify the virus within 10 to 30 days of infection. However, this test is costly and not performed regularly.
Antigen/antibody test: This test catches both the HIV or the antigen and the HIV antibody from your immune system. The test diagnoses HIV within 18 to 45 days of exposure.
Antibody test: As the name suggests, this test only aims at finding the HIV antibodies in the blood and can take about a maximum period of 25 to 90 days after exposure to find them.
ARCHITECT HIV Ag/Ab Combo assay: Compared to previous tests, which could only catch around a third of acute HIV infections, this new antigen and antibody combination assay have a performance level of over 90% of acute HIV infections. In addition, this newer-generation combination HIV tests can provide accurate findings in as little as 12 days, compared to at least three weeks for previous-generation tests.
One key finding is that there is a high possibility of transmitting the infection before seroconversion. There is proof that when the proper treatment is applied in the acute HIV infection stage, it is possible to decelerate the progression of the infection. However, once the virus implants the latent reservoirs, there is no possibility of preventing HIV. Early diagnosis and effective medication and treatment options help people with HIV live longer and healthier lives than ever. On the other hand, chronic infection may take ten years or more, culminating in AIDS sooner in the absence of medication.
Therefore, the treatment aims to reduce the damage to the immune system to prevent getting AIDS and eventually other infections.
Your healthcare provider will give you antiretroviral medications that will block virus activity and stop it from reproducing. These include:
- Protease inhibitors
- Nucleoside reverse transcriptase inhibitors
- Non-nucleoside reverse transcriptase inhibitors
- Integrase strand transfer inhibitors
- Entry inhibitors
Early diagnosis and treatment can also lower your viral load to undetectable levels, preventing you from passing HIV on to others. It can take up to six months for a person to become undetectable after starting therapy, so it’s critical to test and start treatment as soon as possible.
It is usually recommended for people between the ages of 13 to 65 to take the HIV test at least once. In case you have been exposed to HIV, get tested immediately! In case the initial result is negative, take another test. Home testing kits that provide results in 20 mins are available and can ensure confidentiality, but these should always be confirmed with another test, such as Western Blot, or ELISA, performed by a laboratory.
Accurate testing needs high-quality controls and panels that not only provide optimal results to your patients but also preserve your lab’s reputation.
Contact Helvetica Health Care Website today to know how we can help your lab provide HIV-related vital diagnostic services using the most effective panels at our disposal.