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Undetectable Viral Load within 5 weeks of seroconversion
Mar 6, 2011

Request you to kindly address my issue as my HIV specialist is unable to comprehend the HIV lab results:

1. I am a 28 yr old male and was tested positive on 9.1.2011 and again on 12.1.2011 by ELISA antibodies method. I was previously tested 'negative' in April 2010 and August 2010. 2. Upon seeing the positive result, I contacted a HIV specialist who suggested me to undertake a HIV PCR Qualitative test to detect presence of HIV virus and confirm ELISA tests. This was suggested to rule out a false negative as I was previously Hepatitis B positive in May 2008 but cleared the virus and repeatedly tested negative since September 2008 (I tested negative in all tests thereon including a test on 15.1.2011). The HIV PCR Qualitative turned out to be 'Virus Detected' - test was taken on 15.1.2011. 3. I am mostly sure I contracted the virus on 25.12.2010 during a sexual intercourse. When I got the ELISA and PCR Qualitative tests done between 10.1.2011 to 15.1.2011, I was still seroconverting as I had all symptoms such as feverish sensation for good 2 weeks since then etc. 4. My HIV specialist suggested that I get a HIV Viral Load and CD4 test undertaken after 4-6 weeks of seroconversion as the Viral Load would stabilise then from the initial high levels and we can plan for treatment course if necessary. Accordingly, I got the tests undertaken on 14.2.2011 and retest on 21.2.2011 - in both these tests, the CD4 count was 620 and Viral Load was undetectable.

My doctor and I are both surprised at the 'undetectable' viral load - usually the viral load is expected to be in thousands during the initial stages (first 6-7 weeks of infection). I have not taken any HIV medication so far which would have resulted in an undetectable viral load. My questions: 1. Could there be an explanation for the undetectable viral load during this period? 2. Larger question, can there be a small possibility of a false negative in the ELISA antibodies report and/or the HIV PCR Qualitative test? 3. Is or can there be any link to my previous Hepatitis B positive status? 4. I used to previously (upto the date I came to know I am positive) use 'Poppers' - Nitrite inhalants occasionally (once a week). Can the positive ELISA antibodies result or 'detected' result on HIV PCR Qualitative test be due to this?

Many Thanks for your time and expert opinion in advance.

Response from Dr. Holodniy

You don't indicate whether a confirmatory western blot test was performed and if the results of that test were positive. if both the HIV screening EIA and western blot test are positive, then yes, an undetectable viral load could be seen in the face of early HIV infection.



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