Sep 4, 2012
Dear doctor Young,
I would like to ask two questions but before I do that let me please thank you for all your help and dedication you have been showing on this site.
1) I started ART in April after being diagnozed in January this year. I was put on Atripla (split into the three basic components as individual pills). Except for an old HAV infection I am without further comorbidities, 26 y.o. smoker. My initial results in Jan were VL 149,000 CD4 474, In Apr bebofe treatment VL 117,000 CD4 486, in Jul VL 290 CD4 604. Liver and kidney function optimal. Would you say that I can reach undetectable levels before my next tests in November?
2) Based on this article: www.thebodypro.com/content/68450/hiv-transmission-risk-chart.html?ap=2009 I see that oral sex transmission is low. If I am on ART, free of any STDs and getting close to <40 VL, would you say that unprotected oral sex with my negative boyfriend is safe? I do not want to put him any risk but cannot imagine having oral sex with condom...
Thank you once again
Response from Dr. Young
Hello Martin and thanks for posting.
1) Yes, I'd expect your viral load test to reach undetectable levels in November, 5 months or so after starting Atripla treatment. I usually obtain a monitoring test about 1-3 months into treatment to make sure that the initial trajectory of the viral load is good.
2) Oral sex is generally low risk for HIV transmission; even lower if the positive partner is on ART and has an undetectable HIV viral load. Recall (I think as you allude to) that other STDs can easily be transmitted this way- syphilis, gonorrhea, chlamydia and papilloma virus.
I hope that helps. Be well, BY
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