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Newly positive, still ELISA negative

Jan 10, 2001

I visited my doctor with severe flu-like symptoms (it was acute HIV). He ran an ELISA antibody as well as an RNA test. The ELISA came back negative, but the VL was over 750,000 copies in the Roche test (which exceeded the limit of the test's range). The lab lost my CD4 blood samples twice (fools!), so we have no idea what they are, but I am now feeling better from the acute phase. As I will be seroconverting very, very soon, should I start HAART meds immediately, or wait to get a baseline VL after I level-off in a few weeks/months? I was still ELISA and Western-Blot negative as of two days ago, and the doctor is watching me very closely (I guess I'm somewhat of an oddity: HIV positive and still antibody negative). My doctor just happens to be an infectious disease specialist, and he has referred me to an HIV specialist, so that's why he was so thorough and caught me just 14 days after my infection.

Response from Dr. Holodniy

Starting treatment during acute infection is still controversial, and should probably be done under the auspices of a study. Some experts believe that early treatment maximally preserves immune function. Others believe that treatment should be delayed as long as you are healthy and your CD4 count is stable, as long as the viral load is not terribly high (say > 10-20,000/ml). Talk to your doctor about the pros and cons.


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