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conflicting or misunderstanding?

Feb 1, 2011

hello DR BOB!: I have some confusion about the HIV. I read you said:"It may take up to ten years after primary infection for HIV/AIDS symptoms to become manifest; however, that doesn't mean HIV has been lying "dormant" all that time. HIV remains very active throughout this "clinically latent" (symptom-free) period."

But in another thread on this forum,Dr. Holodniy said"Yes it can remain dormant, no the antibody test will be positive".here is the link of his answer:(

do i misunderstand his"dormant"statment or is there some conflicting information here? Is his"dormant" means the same as your"dormant"?

Response from Dr. Frascino


Conflict? No. Misunderstanding? Yes. I can assure you Dr. Holodniy and I absolutely agree on these issues.

I was addressing the "clinically latent" period of HIV disease, during which an infected person may feel quite well and not even know he is infected. I used the word "dormant" to refer to the HIV infection in general. In essence I wanted to explain that even though a person infected with HIV may feel well for years, that doesn't mean the virus was inactive (dormant). In fact during this period the virus is very busy destroying CD4 cells. Once the immune system has become impaired (deficient), the infected person becomes susceptible to opportunistic infections and malignancies. This is when he or she becomes symptomatic. The symptoms are related primarily to the opportunistic process (MAC, PCP, CMV, etc.). It may take up to a decade for this to occur. So I was indicating the viral infection was not dormant (sleeping) during this period.

Dr. Holodniy was addressing a different aspect of HIV disease entirely. He was referring to HIV viral reservoirs. HIV infects cells using an enzyme called integrase. Integrase allows the virus to "integrate" its DNA into the host DNA. One of the types of cells HIV can infect are memory T-cells (CD4 cells). A very small percentage (one in a million) of these memory T cells become "dormant" sleeper cells. They can remain "asleep" for decades. The dormant cells that are infected with HIV constitute the "latent HIV reservoir." These sleeper cells can be awakened by a stimulus or immune challenge. Once awakened, these cells behave like all the other HIV-infected cells. They start replicating, producing new copies of HIV. I know this is a rather confusing concept. I've just completed a three-part blog for this site that addresses strategies for an HIV cure. In the blog I discuss this "dormant" viral reservoir. Take a look at the blog when it gets posted. I think it will help clear up any ongoing misunderstanding or confusion.

Dr. Bob

dark days,worried,please help me by answering.

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