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How is it possible.......
Apr 13, 2008

My husband of 10 yrs, and the father of my 4 children tested HIV positive in July 2007 (actually has an AIDS diagnosis: CD4 count of 88 & VL of 7940 per tests on 7/26/07). Started HAART immediately and results have been as follows: 10/12/07 - CD4 149 & VL 60 1/08/08 - CD4 128 & VL <50

He says the last sexual encounter he had outside the marriage was in 2001. The children and I have tested negative. I tested at 6weeks, 3mths, 6mths after finding out his results. Questions: 1. How is it that I have not been infected this long? How is this explained? 2. Is it possible that I am HIV positive too and that my VL is undetectable and that's why I get a negative result? 3. In 2004, I developed some purple pearly bumps (itchy pimple like) on my chest which I understand may be a symptom of HIV infection - how do I tie in all this with the fact that I am still negative?

Please help - I am scared to death.

Thanks for all you do for this forum.

Worried MOM

Response from Dr. Frascino

Hello Worried Mom,

I'm sorry to hear about your husband's recent AIDS diagnosis. I'm glad he is now on HAART and that his viral load has now been suppressed to undetectable levels. Hopefully his CD4 count will now begin to climb.

Regarding your specific questions:

1. Luckily not every HIV exposure leads to HIV transmission. In fact most HIV exposures do not result in HIV transmission! There are many factors involved in whether the virus is transmitted or not. These include both viral factors, such as viral strain and viral load, as well as host factors, such as genetics, immune integrity, local trauma, concurrent infections, etc. Certainly it is possible that a single HIV exposure could lead to HIV acquisition, but there are also many cases like yours where repeated exposures did not result in viral transmission.

2. No. Your repeatedly negative HIV tests out to six months are definitive and conclusive. You are HIV negative. HIV screening tests have nothing to do with HIV plasma viral load. Screening tests check for anti-HIV antibodies, which are circulating proteins made by the immune system in response to an HIV infection. Even if an HIV-infected person had an HIV plasma viral load that was undetectable (like your husband's), he/she would still test HIV positive on HIV-antibody tests.

3. That's an easy question! The answer is the "purple pearly bumps" have absolutely nothing to do with HIV!

Stop being scared. You dodged the HIV bullet! You should be WOO-HOOing, not worrying! I would suggest you and your husband read through the information in the archives of this forum pertaining to magnetic couples (one poz, one neg) and also the sections on HIV transmission and prevention.

Good luck to you both!

Dr. Bob



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