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again non seroconverters

Sep 7, 2006

hi doc,

I asked this question about non seroconverters and you replied saying if I had 17 hiv antibody tests and none tested positive i needn't worry. That's easier said than done, however. i have read numerous articles on people with hiv who don't seroconvert. it has got me worried. i mentioned I have thrush and you questioned it. now I have neuropathy. how do I know? because my muscles keep trembling all the time. It's like an earthquake going around throughout my body. I am sending you a write-up on serongative aids patients so that you can read for yourself. Am I a goner, doc? It's been 16 years since I have had my last exposure to HIV and now I have no energy, thrush not to speak of neuropathy. Wonder what you have got to say. --------------------

Conference Coverage (Retrovirus): Seronegative HIV Infection: Good News or Bad? AIDSWEEKLY Plus; Monday, February 8, 1999 Daniel J. DeNoon, Senior Editor

Some people with HIV infection remain negative on HIV antibody tests, a two-year study proves. T. Zhu and colleagues at the University of Washington have found HIV lurking in the resting T cells of some people who remain HIV seronegative All 37 of members of the study cohort continue to test negative for HIV despite repeated high-risk sexual activity with their HIV infected partners. "This is the first demonstration that latent HIV-1 infection can occur without subsequent seroconversion," Zhu reported in a presentation to the 6th Conference on Retroviruses and Opportunistic Infections, held January 31-February 4, 1999, in Chicago, Illinois. The researchers consistently detected HIV env, gag, and pol gene sequences in resting T cells from the exposed seronegative individuals over a two-year study period (1996-1998). They had their results checked in different laboratories at different time points to rule out contamination with reagents and cross contamination between samples. Of extraordinary interest was the finding that the HIV gene sequences from these individuals did not vary over time. Virus from only one study member had sequence variations, and these were small. Such genetic constancy could not occur if HIV were replicating normally, as the virus is notoriously prone to spin off viable mutants known as quasispecies. "HIV-1 did not replicate or replicated at extremely low level in most exposed seronegatives, which resulted in sequence identity in cells from 1996 to 1998," Zhu observed. Because the virus remained virtually unchanged, Zhu and colleagues concluded that the individuals had not been infected with other strains of HIV-1, even though they continued to have unprotected high- risk sex. The implications of the findings could be immense. Is there a population of seronegative individuals who believe themselves to be uninfected but in whom normal HIV replication may one day break out? Can these people infect others? Or are they effectively vaccinated against HIV? It will be of urgent interest to AIDS vaccine research to discover how these individuals manage to keep their HIV infection in a latent state that seems to protect them despite a lack of antibodies. 990208

Response from Dr. Frascino


It's been 16 years since your last potential exposure to HIV; you've had 17 negative HIV tests and you're wondering if you are a goner because of an article from February 1999 about "seronegative HIV infection????"

My assessment has not changed:

1. Your thrush is most likely not thrush, and even if it is, it has absolutely nothing to do with HIV disease.

2. Your neuropathy ("muscles keep trembling . . . like an earthquake going throughout my body . . .") is not neuropathy. Period.

3. You do not have HIV. No way. No how.

The article you reference from February 1999, concerning seronegatives HIV infection, is ancient history in a field that is moving as quickly as HIV medicine. I could spend considerable time explaining the possible immunologic basis for these findings, but the information is complex and highly technical. I also do not feel it would calm your irrational worries.

Your problem is not HIV, late seroconversion or HiPS (HIV-1-Infected Persistently Seronegative). Your problem is anxiety and irrational fear. I urge you to seek the help of a psychiatrist to help you accept the wonderful news that you are HIV negative. Should you decide instead to continue to perseverate on an illness you absolutely could not have, yes, indeed, you are a "goner."

Dr. Bob

Med Student Confused

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