THE RISK AFTER EXPOSURE OF HIV

The risk of HIV transmission occurring after any potentialexposure to bodily fluids is poorly defined. Within 2 to 6 weeks of anexposure, the majority of infected persons will have a positive HIV antibodytest, with virtually all being positive by 6 months.

The test used most commonly for diagnosing infection with HIV is referred to asan ELISA. If the ELISA findsthe HIV antibody, the presence of the antibody isconfirmed by a test called a Western blot. During this period of time shortlyafter infection, more than 50% of those infected will experience a"flu-like" or “infectious mono-like” illness for up to several weeks.This illness is considered the stage of primary HIV infection.

The most common symptoms of primary HIV infection are :

• Fever
• Aching muscles and joints
• Sore throat
• Swollen glands ( lymph nodes ) in the neck

It is not known, however, why only some HIV-infected personsdevelop these symptoms. It also is unknown whether or not having the symptomsis related in any way to the future course of HIV disease. Regardless, infectedpersons will become symptom-free ( asymptomatic ) after this phase of primaryinfection. During the asymptomatic phase, infected individuals will knowwhether or not they are infected only if a test for HIV is done. Therefore,anyone who might possibly have been exposed to HIV should seek testing even ifthey are not experiencing symptoms. HIV testing can be performed by a physicianor at a testing center.

During the asymptomatic stage of infection, literally billions of HIV particles( copies ) are produced every day and circulate in the blood. This productionof virus is associated with a decline ( at an inconsistent rate ) in the numberof CD4 cells in the blood over the ensuing years. Although the precisemechanism by which HIV infection results in CD4 cell decline is not known, itprobably results from a direct effect of the virus on the cell as well as thebody's attempt to clear these infected cells from the system. In addition tovirus in the blood, there is also virus throughout the body, especially in thelymph nodes, brain, and genital secretions. The time from HIV infection to thedevelopment of AIDS varies. Some people develop symptoms, signaling thecomplications of HIV that define AIDS, within 1 year of infection. Others,however, remain completely asymptomatic after as many as 20 years. The averagetime for progression from initial infection to AIDS is 8 to10 years. The reasonwhy different people experience clinical progression of HIV at different ratesremains an area of active research.

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