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Viremia in the blood semen and gut
Sep 2, 2008

How is possibile, during haart, to find hiv virus in semen while the blood viremia is below the limit? Where does these virus come from?.. I understood that the virus is still replicating in semen, in the gut, while there is no replication in the blood. It is strange, because it seems that haart is not so good as i thought.

Response from Dr. Frascino

Hello,

Well HAART may not be as good as you thought, but it's still nothing short of miraculous in my book! The absolutely astounding and sustained decrease in HIV/AIDS-related morbidity and mortality since the introduction of highly active antiretroviral therapy (HAART) is nothing less than unprecedented and must be considered one of science's greatest achievements. It's not a cure. We all realize that. I also realize that without it I wouldn't be here responding to your question. (I'd be in a designer urn on Dr. Steve's bookshelf.)

Your observation/question points out one of the major obstacles we have in developing a cure. HIV is not only located in blood; it resides as a tiny piece of genetic material that gets incorporated into our cells. Antiretroviral drugs that we swallow get absorbed into the bloodstream and carried throughout the body. The drug concentration in the various body compartments, tissues and organs varies as it does with all drugs. Consequently, how much active antiretroviral drug actually gets into seminal fluid, vaginal/cervical fluids, spinal fluid, the brain, etc. can vary considerably. We are continuing to work on these and other challenges as we march toward the holy grail of viral eradication (cure). Stay tuned, but don't dish HAART. It's a milestone we couldn't live without . . . literally!

Dr. Bob



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