An unusual seroconversion profile in a pregnant woman infected with the human immunodeficiency virus-1: Need for using later generations HIV screening assays

The first HIV-1 marker that appears in blood following infection is HIV-1 RNA and usually the load is in millions of copies/ ml preceding seroconversion. A 24-year-old pregnant woman, gravida 2, parity 1 was tested for HIV as part of antenatal screening. Three samples were collected and tested from this individual over a period 70 days. The HIV-1 RNA level during seroconversion phase was very low contrary to the well understood natural history of HIV infection. The reactivity rate in the ELISA and the Western Blot profile showed a gradual increase over the 70 days with a weak reactivity in a second generation assay (detects IgG only) for the third sample. This case illustrates the uncertainties regarding the serological window period in HIV infection and the need to use at least a third generation assay in testing centres for early detection of HIV infection.