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Resistance to HIV infection
Feb 16, 2010

Hi, doc. I have been exposed to HIV numerous times through unprotected oral and anal sex with a gay HIV+ men, some also being in the primary HIV infection status (just receintly infected, but unaware of it).

What is it that brings such amazing resistance to HIV infection in my body? It was something, not just a shere luck.

Thanx.

Response from Dr. Frascino

Hi,

Most likely it has indeed been sheer luck. Have you considered a quick trip to Las Vegas? It's worth noting that not all HIV exposures lead to HIV transmission. In fact most, thankfully, do not. You can review this information in the chapter on HIV statistics in the archives of this forum.

If it's not sheer luck, it's possible you have a genetic mutation that confers some degree of resistance to HIV infection. (See below.) In either case, sheer luck or Delta 32 mutation, your luck could run out at any time. I strongly encourage you to properly suit up before any further sexual encounters. The old adage, an ounce of prevention is worth a pound of "antiretrovirals," certainly applies.

Be safe. Be well.

Dr. Bob

CCR5-Delta 32? Dec 11, 2009

My ex-wife has HIV. We had unprotected sex. The last encounter was seven months ago. I tested twice for HIV and was still negative after seven months. My GF is a med student and is worried that I may be able to transmit HIV seven months after exposure if I have CCR5-Delta 32 immunity. I read somewhere that the virus can only survive, unattached, in the blood stream for six to twelve hours. Do you believe I can still transmit HIV even though negative?

Response from Dr. Frascino

Hi,

Your GF may be a med student, but she still has much to learn when it comes to HIV transmission! Your negative HIV tests out to seven months are definitive and conclusive. HIV is not your problem. No way. No how. No additional HIV testing is warranted.

The delta 32 mutation blocks CCR5 (but not CXCR4) virus from infecting cells. It has nothing to do with being "able to transmit HIV seven months after exposure!"

I'll reprint some information about the delta 32 mutation below. Share it with your girlfriend, OK?

Good luck.

Dr. Bob

To med or not to med (DELTA 32 MUTATION) (WHEN TO START TREATMENT, 2009) Nov 29, 2009

Dr. Frascino

I was diagnosed 5 years ago as being HIV positive, which was kind of a shock considering I had done a study in San Francisco that said I lacked some gene that allowed the virus to attach. Anyway here I am 5 years later and my viral load has never gone up past 500 and is currently 126 and my T-Cells have never been under 700 and is currently 845. When I asked my doctor what he thought, he said that I was lucky, but then suggested I started medication anyway just to help out. If my body is fighting off the virus on its own, why would I want to start a lifelong commitment to taking meds? Am I fooling myself in thinking my body has it handled? and could it have to do with the test I took in SF that said I lacked some protein? Any advice would be greatly appreciated. Thank You

J

Response from Dr. Frascino

Hello J,

Regarding the gene mutation, I would assume it was the delta 32 mutation, which confers resistance to some, but not all, strains of HIV ("CCR5" virus can't get in, but "CXCR4" can). This is one of the worries about folks misinterpreting what this genetic mutation actually means regarding the potential for acquiring HIV. (See below.)

As for whether to begin treatment, it's an individual decision. Some recent information suggests starting early to preserve immune function and block damaging immune activation. (See below.) However, these potential benefits must be weighed against the risk of short- and long-term side effects and toxicities as well as the inconvenience and cost of early intervention with combination antiretroviral treatment. I would suggest you discuss this in detail with your HIV specialist. And, if you remain uncertain, get a second opinion from another HIV specialist in your area.

Good luck.

Dr. Bob

Had unprotected sex with a guy who has ccr5 delta 32 (DELTA 32) Oct 13, 2008

Last night I had unprotected sex with a guy who claims that he has ccr5 delta 32 and got a negative HIV test recently. I'm worried about it as his ex is positive. My question is do people who have ccr5 delta32 carry HIV? Is the risk of me getting HIV low? Shall I take pep or go to get a test? Thanks a lot!!

Response from Dr. Frascino

Hello,

Even if a guy strapped a lie detector on his Mr. Happy, I wouldn't believe claims that unsafe sex is not risky, because your partner states he's "delta 32." I'll reprint below some information from the archives pertaining to delta 32.

Your HIV-acquisition risk should be considered the same as that of anyone else who elected to have unprotected sex. PEP would only be recommended if your partner was confirmed to be HIV positive (or strongly suspected of being HIV positive) and if you had a significant exposure. I can't tell from your question what type of "unprotected sex" you had with Delta-Dude, but I doubt PEP would be warranted. Testing, however, at the three-month mark is warranted. I urge you to reconsider your decision to place yourself at risk for STDs, including HIV, by barebacking.

Be safe. Be well.

Dr. Bob

No HIV in 8 years (DELTA 32) Nov 1, 2007

To Whom It May Concern:

Thank you for your time in reading this. I am writing to ask a question. A good friend of mine is a homosexual male. I have personal knowledge that my friend has had receptive anal sex with over 1,500 men over the past 8 years. My friend frequents hot spots in local parks and public restrooms, and finds sexual partners on the internet. According to my friend (and I find this information credible), over 90% of his sexual encounters were unprotected and most of these men have ejaculated into his rectum. Some of the men who have ejaculated in my friends rectum are HIV positive.

Notwithstanding the fact that my friend has had unprotected sex with this many men, a recent HIV test was negative.

Having had unprotected anal sex this many times and with some known HIV-positive men, why hasnt my friend become HIV positive? Is there anyone, perhaps a research institute, who would be interested in a blood sample of my friend for further analysis? It seems like somebody would be collecting this type of data.

Thank you so much in advance for your response,

Concerned with finding a cure as fast as possible

Response from Dr. Frascino

Hello,

Thanks for your post and interest in helping to find a cure as fast as possible.

If your story about your friend is indeed accurate, he is one lucky boy. He's also a boy with significant psychological issues who is courting disaster with his self-destructive and irresponsible behavior. I'm quite amazed he found 1,350 guys (90% of 1,500) willing to have unprotected anal sex with him. Is he a closeted Republican Congressman or clueless rightwing religious zealot perchance? Oh, never mind. Is it possible he could have avoided infection, despite his activities at the hot spots? Yes, it is. Not every HIV exposure leads to HIV infection. Thankfully! Your friend might even have some genetic predisposition against HIV infection. (See below.) The bottom line, however, is that he's putting his bottom at risk with every unprotected poke he gets and sooner or later he's going to lose the STD/HIV sexual Russian roulette game big time. My advice is that you try to convince your good friend he needs help. We don't need his blood, but he definitely needs counseling and a change in behavior ASAP.

Dr. Bob

HIV+ Resistant Sep 12, 2007

Dear Bob,

Six month after he left me, My boyfriend send me a letter to tell me he had been tested positive and had developped aids. We had been together for two and a half years. We had unprotected sex many times, almost daly. He thinks he was infected throughout our relationship. I received loads from him in my mouth as much as in my ass. I got tested when I received his letter and was diagnosed negative. I got tested every year since then and still negative. It has been five years now and I have had other relationship with many partners. Is it possible that I am immune against the virus. That my body is protected against it. Is there a test we can take to see if our immune system can fight the virus on its own. If so where can I take such a test. I live near Montreal in Quebec, Canada. Thanks for your time. Cheers, Eric

Response from Dr. Frascino

Hello Eric,

Are you immune to HIV? No, most likely not. What you are is damn lucky! I urge you not to push your luck by assuming you are immune. That's playing sexual Russian roulette and ultimately you will lose.

I will reprint below some information from the archives concerning the Delta 32 mutation. This is an evolving story. Even with the mutation you would not be immune to all types of HIV.

Stay safe. Stay well.

Dr. Bob

delta 32 Mar 17, 2007

Dr. Bob ...

I think I may have heard everything now! So, I'm on Craigslist just 'poking' around and I see this guy who wants to have sex - but, he only does it bb. Now, here is where it gets wacky! He's HIV Negative and says, "I just got tested in January, but, I just do that so guys will know the right answer. I don't worry about HIV ... I'm delta 32."

What does that mean? I went to a link, that he provided, and it talked about smallpox, and the plague.

What gives? Is this guy a bit crazy or is he really "safe?"

Can you shed some light, my friend?? :)

Thanks!! Oh and P.S., I thought I found Prince Charming ... But, it wasn't him! I'm still looking! You have any cute friends in Orange County?

QS

Response from Dr. Frascino

Hey QS,

So you were poking around Craigslist looking for some poking?

Delta 32 is a bit complex to explain, but I'll give it a shot. First, some background. HIV can only infect certain cells that have specific "receptors" on their surface that allow HIV to enter. HIV attaches to CD4 receptors. However, CD4 alone isn't enough for viral entry. Another protein called CCR5 is also needed. CCR5 is called a co-receptor. Some folks have a mutation in the CCR5 gene called CCR5-delta 32 mutation. This mutation changes the configuration of the CCR5 protein such that HIV cannot bind to it. Genes, of course, are inherited. If you inherit a CCR5-delta 32 gene mutation from both parents, your chances of becoming HIV infected are dramatically reduced. This occurs in about 1-3% of Caucasians. If you inherit one CCR5-delta 32 mutation (from just one parent), it will confer some protection against acquiring HIV and may make HIV disease less severe if you do become infected. Current estimates are that 10-25% of Caucasians may have a single CCR5-delta 32 mutation.

So should Craigslist Delta-32 Boy "not worry" about HIV? Absofrickinlutely NOT! It is downright dangerous to assume you are safe if you have the CCR5-delta 32 mutation. It is not a guarantee of HIV immunity. HIV is much too smart for that. Some strains of HIV use proteins other than CCR5 as co-receptors to enter CD4 cells.

As for the bubonic plague (Black Death) and smallpox link, it appears that the CCR5-delta 32 mutation may have arisen to protect folks in Europe from these illnesses. The mutation affords protection from these ailments and could have arisen via an evolutionary process. (Yes, right-wing religious wing-nuts, evolution does indeed exist!)

So if you happen to hook up with Delta-32 Boy, you might want to give him a science lesson along with his poke.

Finally, hotties in Orange County? Sure, I know some Prince Charmings in that zip code, but unfortunately none are currently single. So I guess you'll just have to continue kissing those toads until your prince arrives.

Good luck.

Dr. Bob



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