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Dra. Rodriguez-Torrres, please help...
Jul 22, 2002

If co-infected at the same time with HIV, Hep B, CMV, we know that normal antibody period may be delayed. Do we know when serum viremia would absolutely be present to diagnose infection? I have intermittently raised ALTs (up to 120) one year after possible exposure, and my testosterone level has dropped to below 200 (I am 35 yo)...all tests (viremia and antibody) for all infections have returned negative out to 12 months. No alcohol or drugs, not fatty liver and Iron/ferritin normal. AST has never been out of limits.. CD4 800/CD19s 6---lowest end of ref range. Does this mean I can't make antibodies? What do I do, and what could it be?

Response from Dr. Rodriguez-Torres

You have excelent CD4,and for most this infections you will develop antibodies as a non HIV patient.If you are negative for C and B,ono year later you are just negative.!!Only in extremely advanced HIV,we may see false negatives for C infection.We suspect also that hidden B disease in HIV is very rare,and only seen in advanced cases.The main immune problem in HIV,is cellular mediated immunity,not antibody production.You are lucky to be negative to C and B,as liver related diseases are the most important cause of morbidity and death in HIV at this moment.



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