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Latent HIV - risk of infection
Apr 18, 2014

Dear Dr. Young,

I understand that currently available ARVs only target free circulating HIV in the blood. HIV DNA integrated into the host cells DNA remains unaffected. My question is, assuming that the amount of integrated HIV DNA is very substantial (whatever that means), how can an undetectable (free circulating) viral load drastically reduce the risk of infection for an HIV- individual? Can the virus not be transmitted in its integrated form?

Thanks a lot for your reply and best wishes from Japan!

Response from Dr. Young

Konnichiwa and thanks for posting your interesting question from Japan.

Your point is a good one, and might apply for blood exposure or injection drug exposures- but most sexual exposure does not involve body fluids with a lot of white blood cells (ie., semen, mucous).

What we do know is that the risk of sexual infection by having an undetectable circulating virus level is very, very low- this has now been shown in several large clinical studies.

Hope that helps, BY

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