Jul 11, 2010
Hi Doctor, I tested positive for HIV 1 in 2008 in the rapid tests. I have had undetectable viral loads and CD4 between 1000-1200 since.My doctor thought am an elite controller. Recently he asked me to take a western blot which says positive for hiv 2 and negative for HIV 1 1. should the tests read positive for HIV I on rapid and positive HIV 2 in western blot 2. how is HIV 2 monitored 3. are there elite controllers of HIV2 4. is it necessary to take DNA PCR 5. could my undetectable VL be wrong because it was never oredered for HIV2 6. Does HIV 2 cause decline of CD4 7. HIV2 seems to be poorly understood do you know of a site/resource that can help me understand it better
Response from Dr. Holodniy
Depending on the rapid test used, there could be cross reactivity or the ability to detect HIV-1 or HIV-2 in the same test. A confirmatory western blot which is specific for each virus is used to determine which virus is causing the infection. HIV-2 infection is usually much slower in terms of disease progression, as CD4 counts tend to be maintained at higher levels for longer periods of time. Many of the HIV medications used to treat HIV-1 will also treat HIV-2 infection. Although you can measure HIV-2 viral load, these assays are not readily available commercially to monitor infection or treatment outcomes. It is also consistent that the HIV-1 viral load assay would not pick up HIV-2 viral load, and so HIV-2 infection would only be confirmed with a specific HIV-2 western blot and HIV-2 viral load.
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