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Dec 2, 2007

hello, thanx 4 the excellent job u do. i was recently diagnosed with a cd 4 count of 360 (11%)and undetectable viral load, of course l was shocked as i have been faithfull to my husband of 13 years, by the way he is negative as well as the 2 girls God blessed us with, my questions are 1 could i have been infected 14 or so years ago before my marriage and still be undectable 14 years later 2 how come my cd4 % is so low at a cd4 360, l am not on treatement as my doctor thinks l do not need to be as yet, though with such a low cd4% here in ireland policy is treatement at cd4 count 200 3 lam worried a lot as l have no explanation to my husband as where i got thre virus from and when as i dont know as l have been 100% faithful to him , l cannot explain all this and its putting a lot of stress on our marriage

l woul be most greafull if you respond to these questions

thanking you in advance me

Response from Dr. Wohl

I assume you have tested positive for HIV with an ELISA (or EIA) antibody test and a confirmatory Western blot. Those tests together are very accurate at diagnosing HIV. Why were you HIV tested?

Your undetectable viral load but lower than normal CD4 cell count presents a mystery. I would check and see if the antibody tests also detect antibody to HIV-2, a virus closely related to HIV-1, the most common type of HIV in Europe and North America. Viral load tests do not alway pick up HIV-2, a virus mostly found in Western Africa and the Caribbean.

There are sophisticated tests that can look for HIV at levels below that of standard assays and I think such testing may be worthwhile. A major university hospital should know what to look for and you should consider referral to such a center.

If you were sexually active or injected drugs prior to your marriage or had a transfusion with blood or other blood product, then you could have been exposed to the virus at that time. Have you ever been tested before for HIV or donated blood (typically blood donors are tested for HIV).

Until your situation becomes clearer, it is difficult to recommend HIV therapy.



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