Mar 18, 2006
Six months after being infected, my VL was <400, CD4 in the 750s and percentage 38%. (I've written earlier about this, answered on February 12.) The nurse-practitioner I'm seeing is so puzzled that she's ordered a repeat EIA (and, presumably, a confirmatory WB). Are there cases in the literature where someone has "eliminated" HIV from his or her body? I'm not clutching at straws, just scientifically curious. (My EIA and WB were positive in January, with five bands present in the WB.)
Along with the antibody tests, she ordered an ultrasensitive VL test (after all, the level could be 390 or something). But the detectability threshold for this -- it's a Roche PCR version I think -- is 50 copies. Is that standard? I've certainly had friends take tests (in other countries, admittedly, not the US) where the detectability threshold was 20 copies. And I've recently heard that there are ultra-ultrasensitive tests being performed in Europe that can go as low as <5 copies. So: a question about HIV "elimination," another about 50 vs. 20 copies, and a third about superduper-sensitive tests (perhaps approved only for research/lab purposes?).
Response from Dr. Holodniy
There a small minority of people who are HIV infected and have undetectable plasma levels of viral load, as defined as < 50 copies/ml. Yes, there are assays out there that go down to zero, whatever that means. People will have evidence of HIV infection by detection of HIV in blood or lymph node cells, even in the absence of a detectable blood plasma viral load.
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