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Subject:
From:
Fiona Coombes <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 15 Jul 1996 07:28:42 +0000
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Kathleen
I agree with what you say about the window between actually catching
the HIV virus and it showing up in HIV testing. IN the cases quoted,
how do the doctors know that the mother definitely developed HIV in
the postpartum period, unless they were very regularly checked during
pregnancy. Even then, the variation in the time between catching HIV
and it showing in tests is so much as to make any estimation of exact
time of catching it very difficult. In most cases, the person will
become HIV positive 2-6 weeks after catching the HIV virus, but this
can take up to 3 months to happen.
The only time that you could say with more confidence that the mother
caught HIV at a particular time is if she was tested and diagnosed
during the seroconversion illness (eg the illness may people get when
they first catch HIV). However, this illness does not occur in all
cases, and asymptomatic seroconversion does occur. When the HIV virus
firsts enters the body, there is a 2-4 week period of rapid virus
replication before the seroconversion illness takes place.
If  the infant is infected by the mother before birth, it will be HIV
positive at birth, but these could be maternal antibodies and not the
babies own antibodies. Consequently, using the HIV antibody test by
itself is only useful after the baby is 15-18 months old. Before
that, more information can be got by PCR tests, and other measures of
the baby's immune system. This is why some babies test positive at
birth and are negative at age 12 months - they only had maternal
antibody and were not actually infected themselves.
The information I am basing these comments on comes from a 1993 book
edited by Graeme Stewart, the Director of Immunology at Westmead Hospital
and Associate Professor of Medicine at the Uni of Sydney Australia.

Hope this helps
Fiona Coombes   Doctor and LC  Perth Western Australia
Fiona Coombes MBBS IBCLC               [log in to unmask]
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Lactation Consultant, Family Physician     Perth Western Australia

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