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undetectable
Jun 10, 2012

this is my first time visited the website. i was told in 2004 i had hiv.they told me i wound be dead in five years.now am undetectable and my cd4 an other numbers are in the 750.is that normal

Response from Dr. McGowan

Thanks for your question.

I assume you are not on meds? On treatment that would not be unusual, that is the norm.

If you are not on treatment, you may be what is referred to as an 'Elite Controller". This is a person who has undetectable viral load not on treatment. Only about 1 in 200-300 people with HIV infection will fall into this category. There are several possible ways that this can happen. One way is the you may have been infected by a defective virus that does not grow well, this is very rare. Another way is that your immune system may be set up in just the right way to be effective in suppressing the virus strain that you were exposed to. Yet another way may be that your immune system is made up in such a way that you CD4 cells have an altered co-receptor protein on their surface...the co-receptor is needed by HIV to attach to your CD4 cells. If yours is different then the virus can't enter the cell. You may have read about "the Berlin patient" who was functionally cured when he got a bone marrow transplant from a donor with a mutated co-receptor...this may occur in 1-5% or more of people depending on your heritage (more likely from Northern European stock).

So, it is important to keep going for check-ups because even elite controllers can have some progession of illness and loss of CD4 cells. It takes some energy to contain the virus and that inflammation can cause a drop in CD4 over time. Also, you can get infected by HIv strains that your body may not be able to contain, so you still need to practice safe sex (use condoms). You are not "immune" from all types of HIV.

Best, Joe


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