Important note: Information in this Q&A was accurate in 2009. The state of the art may have changed since the publication date. I was told two weeks ago I am HIV positive? Is there a way to tell how long I've had HIV?
This short answer is: "no, not really". But there may be some additional information that could be somewhat useful.
Most HIV testing sites use a standard antibody test followed by a confirmation with another antibody test called a Western Blot. These tests can generally find HIV within 2 - 4 weeks after infection, though it is possible that it could take up to several months for these tests to turn positive. These tests can't actually tell when you picked up HIV. However, the Western Blot identifies each specific HIV antibody, and we can "somewhat" surmise that if only a few of the primary antibodies are present then the infection contact may have been somewhat more recent - say in the past few months. But it is important to remember that this is more intuition than science.
Another way clinicians can get "a feeling" for how long a patient has been positive is by looking at the viral load and t-cells. If a patient has low t-cells and/or a high viral load then it is more likely that the patient has been positive for a least several years. But the range of time we are talking about is very broad. Some patients will drop t-cells within a couple years, but others may take a decade or more.
The exception to this rule is acute seroconversion - during the first 1 - 3 months of HIV infection the virus can multiple rapidly causing an initial spike in the viral load and drop in the t-cells. But these abnormalities usually correct in a couple months.
Just to complicate matters, some testing sites are now using nucleic acid amplification to detect HIV. This test can find the HIV nuclear material in the very first weeks of infection before the antibody tests become positive. If this test was use for you and at the same time a standard antibody was run which was negative, it would tell us that you are within the first few weeks of HIV infection.
Now just to cover all the bases, you may read about a "detuned" HIV test. This is a research tool that identifies only higher levels of HIV antibodies. So if your initial antibody was positive but a repeat detuned test was negative, it would imply that you were infected within approximately that last 6 months. This test is not commercially available.
The bottom line is that we cannot accurately pinpoint how long you have been positive. The best we can do is estimate by inference in a very broad and vague range of months to years.
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