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Being a Carrier
Sep 28, 1999

My question is: Can you be a carrier of this desease like some of the other deseases in which people can be carriers of it and not be affected by it?

Response from Dr. Reznik

The following information is from the Clinical Management of the HIV Infected Adult which is put together by the Southeast AIDS Training and Education Center and the Midwest AIDS Training and Education Center. The key piece of information contained here, is that HIV infection can be asymptomatic for many years. There are a few people who have been referred to as non-progressors, where the CD4 cells do not appear to be affected for a very long period of time; but to directly answer your question, there is not any documented evidence of people being carriers and not being affected.

T-lymphocytes (or CD4 cells) are primary attack cells for HIV. Three measurements of T-lymphocytes have clinical implications in the management of HIV-infected patients: absolute CD4 count, CD4 percent (the percent of T-lymphocytes with the CD4 surface receptor), and the CD4: CD8 ratio (T-helper: T-suppressor ratio). As HIV infection progresses, all three of these indices decline. The CD4 panel is used for staging and definition purposes, and to determine when to start a particular OI prophylaxis. Taken alone, it is less useful than virus load in predicting risk of progression, but the two used together give a more accurate estimate of disease progression risk. (See HIV-Specific Labs.) STAGING BASED ON CD4 COUNT: Dr. Paul Volberding of the University of California at San Francisco / SFGH developed the following disease staging classification for HIV based on CD4 counts:

STAGE TYPICAL CD4 COUNT TYPICAL DURATION Acute/Primary HIV 1000 - 500 1 - 4 weeks Asymptomatic 750 - 200 2 - 15 years

DR


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