What Is HIV Seroconversion?

Medically Reviewed by Jonathan E. Kaplan, MD on July 18, 2023
4 min read

Seroconversion is a general term for the time between exposure to a virus and when antibodies show up in your blood. Antibodies are proteins that help your body fight against viruses, bacteria, and other germs.

HIV seroconversion, specifically, is the time from HIV exposure, to infection, and to developing antibodies that can be detected by a test. This can take a few weeks and is sometimes called the window period.

HIV is a virus called human immunodeficiency virus that attacks your immune cells called CD4 T lymphocytes, which causes your immune system to fail. Without these cells, your body can’t fight off other infections and diseases. ‌

You can get HIV when you’re exposed to blood, anal fluids, vaginal fluids, or breastmilk from someone who has HIV. This most commonly happens from: 

  • Having unprotected anal sex
  • Having unprotected vaginal sex
  • Sharing needles, syringes, and other drug equipment
  • Mother to child during birth and breastfeeding‌

There are several stages of HIV infection and the seroconversion timeline. These are:‌

Viral transmission. This happens when you are exposed to the virus.‌

Acute HIV infection. Sometimes called acute retroviral syndrome, this stage is when you become infected. The virus makes a reservoir of infected cells that continually releases virus into your body. Some of the virus goes to replace reservoir cells, and some goes to create more active infection.‌

In this stage, you:

  • Have very high amounts of HIV virus in your blood
  • Are very contagious
  • May have flu-like symptoms
  • Might not feel sick‌

Seroconversion. This happens as part of your infection stage. As the amount of virus, or the viral load, rises, your body will start to make anti-HIV antibodies. As these antibodies work, the viral load lowers to a steady state, and your CD4 T-cell comes back up, although it won’t be as high as before the infection.

Seroconversion can take a  few weeks to 3 months, during which time you may or may not have symptoms.

Chronic HIV infection. During this stage, you still have active HIV but at low levels. You might have symptoms or you might not get sick, but you can still pass HIV to someone else. Taking HIV medicine in this stage can lower your risk of moving into AIDS. 

Acquired immunodeficiency syndrome. Known as AIDS, this is the most severe stage that causes serious damage to your immune system. Your CD4 cell count drops, your HIV viral load rises again, and you become very infectious.‌

If you have AIDS, you will get other infections that become serious because your immune system is damaged. Without treatment, people with AIDS can die within two to three years. 

Not everyone will have seroconversion symptoms, but about 50% of people will experience symptoms like:

The symptoms look a lot like other illnesses and don’t necessarily mean you have HIV. The only way to know is to be tested after you’ve been exposed.

There aren’t any tests that can find HIV right after you’ve been exposed. This is because seroconversion hasn’t happened yet. Sometimes the first test can come back negative even if you have HIV. Seroconversion is different for every person.‌

Your doctor might use different tests, including:‌

Nucleic acid test. Also called NAT, this test can find HIV sooner than others, usually within 10 to 33 days of an infection. It’s a very expensive test, though, and not regularly used.

Antigen/antibody test. This test looks for both the HIV virus, called the antigen and the HIV antibody from your immune system. An antigen/antibody test can diagnose HIV within 18 to 45 days of exposure.‌

Antibody test. This test looks only for HIV antibodies in your blood but can take 24 to 90 days after exposure to find them.

There is no cure for HIV, but it can be controlled. Even though your body makes antibodies against HIV, they’re not strong enough to fight off the infection by themselves. Without medication, a chronic infection can last 10 years or longer and can move you into the AIDS stage sooner.‌

The goal in treatment is to stop your immune system from being so damaged that you get AIDS and other infections. 

Your doctor will give you antiretroviral medications that will block virus activity and stop it from reproducing. These include:

Early treatment is important. If you think you’ve been exposed to HIV, talk to your doctor. While seroconversion takes time and they won’t be able to find it right away, they can give you some medication to prevent an infection.