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Re: Undetectable Viral Loads Without Meds
Aug 10, 2002

Dear Mark - thanks for your quick reply. Just for clarification, if the patient was never detectable on viral load, even during what seemed to be an acute/primary stage of infection, then what would prompt an antibody response in the blood? I have a patient with generalised lymphadenopathy beyond 6 months but -ve on Elisa 1/2, and ALWAYS undetectable on bDNA and PCR. I have told him that even if virus is undetectable in the blood, serology by this stage (6 months post exposure) will still be positive.However he posed the question to me 'if virus has never been detectable in the blood how could there be (what would prompt) an antibody response in the blood?' I did not have an answer to this. Could HIV be contained in the lymphatic system and thus prevent/delay an antibody response?

Many thanks again

Response from Dr. Holodniy

I am still waiting to see a documented case of acute HIV infection where the viral load and/or antibody tests in blood are negative and continue to remain so. The blood stream is not a sanctuary site/compartment. It is reflective of ongoing pathology from many diseases in many organs. HIV is no exception.



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