Dear Mark, I understand that even if a patient on HAART has an undetectable viral load, virus may still be trapped in other areas of the body, particularly the lymphatic system. However can a patient who has NEVER been on meds continually have an undetectable viral load (bDNA and RNA PCR) but still harbour virus within other parts of the body? If so would serology still be positive? If yes then how could this be - if the virus has never been detectable in the blood how could there be (what would prompt) an antibody response in the blood? Net net, is it possible for a patient to be always negative/undetectable on all blood based tests but still harbour virus in other parts of body?

Many thanks the site and your expertise is very helpful

Serology will be positive in people with undetectable viral loads and not on meds. They most likely had high positive viral loads during acute infection, which is what prompted the immune system to develop both a good cellular and antibody response to the virus, which they still would have, but replication is contained.