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Can body's own response limit viral load?
Aug 24, 1998

Dear Dr. Holodniy,

Almost four months after a high risk exposure with a known HIV+ individual, I tested ELISA negative and super-sensitive HIV - 1 DNA by PCR negative. These negative tests followed a two week bout with ARS-like symptoms (during the 4-6 week post-exposure period). Is it possible that my body's response has reduced the viral load to below detectable levels for the time being and that later I will test positive? If my body has reduced the virus to below detectable levels after 4 months, wouldn't I test postive on a standard antibody screen? Thanks!

Response from Dr. Holodniy

It's possible, but unlikely that you would be infected and have no evidence of HIV infected cells (what DNA PCR measures) in your blood. Plasma viral load (which measures cell free HIV virus) could be undetectable by 4 months, but this too would be very rare. ELISA could still be negative by 4 months, but by 6 months would be positive in >99% of people who are infected. A negative DNA PCR and ELISA at 4 months after exposure makes HIV infection unlikely.

MH



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