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Starting treatment with a subtype
Jul 5, 2004

Hi Doctor

This may sound like a strange question. It's not actually as crazy a question as it sounds- one of my ex-partners lived in Africa for a year. But, if I am starting therapy with a CD4 count of 300 after being positive for 3 years do you think it is possible that I could be infected with a rarer subtype of HIV (such as strain O) and not ever know about it? I tested positive by ELISA and WB but if these will most of the time show positive for even the rare subtypes then I could be infected with one of these? Would I ever know? Or would it even matter?

Response from Dr. Young

Thanks for your questions.

The best way to answer your question is to know the clade (family) of HIV that you've acquired. This turns out not to be too difficult, since most HIV genotypic tests also determine the type of virus.

While there is theoretical concern that responses to treatments might be different among different clades of HIV, this has not really been borne out by current clinical studies.

So, it may not matter what strain of HIV you've acquired, outside of the consideration of the acquisition of a drug resistant variant.

Good luck, BY


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