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Question on your response about antibody levels
Feb 22, 2004

Dr. Sherer, Thanks for establishing this very important forum - especially as drug resistance becomes an increasing problem.

In a recent response, you indicated to someone that, even if HIV is completely suppressed to undetectable levels, there would be a sustained antibody response.

How does that recent "Zhu" study out of the University of Washington in Seattle affect this? That seemed to show that, for some, HIV DNA in some infected people can be at such a low level that there is no antibody response - at least for a long time. If this is true for DNA levels, wouldn't it also potentially be true for RNA levels? Or does this and other studies just mean that the initial antibody response is delayed when viral levels are contained in an infected person, but once the antibodies are there, they will always be there - regardless of viral DNA or RNA suppression?

Also, assuming infection and/or multi drug resistance, do HIV antibodies have any value in suppressing HIV and symptoms or are they just irrelevant? Any studies showing that a delayed or lesser antibody response is associated with worse symptoms and a robust antibody response with feeling better?

I would appreciate your take on all of this.

Thanks.

Response from Dr. Sherer

You have provided your own answers quite well.

Antibody levels do vary once infection is established, but the truism that a person once infected is always infected remains true.

And antibody levels are irrelenvant for predicting disease progression. Often they are lowest in patients with the most advanced disease simply due to a weakend mechansim to produce the antibodies.


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