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newly infected boyfriend
Oct 25, 2007

My boyfriend's HIV-antibody test was negative; however his HIV-RNA test returned positive. It is my understanding that a newly HIV-infected individial will have an extraordinarily high viral load; and therefore, the person will be at their most infectious state. When will his viral load level to its "baseline?" When can we resume physical intimacy (with condoms) without "most infectious state" resonating in our heads.

Response from Dr. Frascino

Hello,

If your boyfriend's HIV-antibody test is negative, why was an HIV RNA test performed? The first thing to do is check to see if the positive HIV RNA was a false positive! The sensitivity of HIV RNA tests depend on the viral load, the threshold of the assay and, of course, the status of antiretroviral use. If your boyfriend is indeed very recently infected, it is possible he could be HIV antibody negative but his HIV plasma viral load (RNA) be markedly elevated, thereby increasing his infectiousness. Following an initial "burst" of viral replication (high HIV RNA) during acute infection, the HIV RNA levels do decline to a "set point" as a consequence of seroconversion and the resulting immune response. How quickly this occurs and exactly where the set point will ultimately be is variable from person to person. It usually takes a number of months. Your boyfriend will need to monitor his viral loads and CD4 counts to ascertain his unique set point. As for when you can resume physical intimacy, as long as you use a latex condom properly and it doesn't fail (break), you can resume yesterday!

Dr. Bob



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