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question about "occult HIV infection"&"inactive hiv carrier"
Nov 23, 2010

helloo Dr: I've read some Dr's replies on this forum,and all they said is"either you have the virus or you don't,if you have the virus you will be tested postive". But recently i read some article about HIV ESN(higly exposed but seronegative),the author said one hypothesis which mentioned some ESN have extremely low level hiv DNA in theri T cells or PBMC,and the DNA is higly homogeneous,which means the DNA no replicate or very low level,so they suggested this kind of DNA is dead-end DNA or "silent infection". And because of the DNA level is too low and almost no replicate,which may not be tested out with neither antibody test nor HIV PCR test.the link is here:(http://www.searo.who.int/LinkFiles/News_Letters_HIV-AIDS-Aug-08.pdf) ) Then i started to worry,is there such thing real? have you heard of it or there were some data proved this? Thank you!

Response from Dr. McGowan

Thanks for you post.

It is true that there are people who are repeatedly exposed to HIv but have remained uninfected based on testing (antibody screening and viral loads). It may just be that they are lucky, but most people believe that it is their immune systems taht are somehow protecting them. We know that our genetic makeup determines how we repsond to any particular infection. Some of us are more susceptible to the flu, let's say, than others. Some people get really sick with a cold and others brush it off. These all depend on how our immune system reacts to any specific virus or bacteria. Some of this may be due to the receptors (proteins) that are covering our CD4 cells (some people, for example, are born without an important co-receptor for HIV called CCR5 and can be very resistent to infection). Some may be due to how strong our T cells fight off HIV (called CD8 response). One theory is that people may be infected by a somewhat defective virus that cannot grow and produce a full infection. That is when they find bits of viral DNA in the cells. This may be misleading because HIV belongs to a group of viruses called retroviruses that are commonly found inside human cells. Bits of DNA from retroviruses are in all of our DNA, this may get confused with HIV in these studies. Overall it seems that infection with defective viruses does not account for the majority of these exposed/uninfected cases.

Would not worry about this, after all the main finding is that these people are not infected, or if infected, have fully contained virus. So the danger to them is minimal. They are interesting to scientists to learn about how they stay healthy so we can learn how to tap into that to benefit everyone else.

Best,

Joe



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