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varied questions on HIV/AIDS
Dec 14, 1996

Dear Rick, Thanks for the great job you are doing of informing and educating us about safe sex, HIV, AIDS and other STDs. I have a number of questions for which I have found no answers in your previous responses: 1) How many different ways are there to test for HIV? 2) Why has the term AIDS-related conditions or ARC been abandoned? 3) If people initially started developing AIDS in 1980-81, and if it usually takes 8-10 years from the time of infection to full-blown AIDS, can we concluded that HIV was present in America as early as 1970 if not earlier? 4) If the HIV reproduces itself only in our white blood cells, is it not hypothetically possible that temporarily suppressing the production of white blood cells might actually halt viral replication? 5) I have read that the Pasteur Institute in Paris has documented cases of individuals who have tested seropositive for HIV antibodies, but have consistently tested negative for the virus itself- suggesting that these indiviuals might have sucessfully eliminated the virus from their bodies. Any comments?

Response from Mr. Sowadsky

Hi. Thank you for your questions. I'll answer them one at a time.

1) How many different ways are there to test for HIV?

There are multiple types of tests for HIV. By far, the most widely used and accurate are the antibody blood tests (ELISA/Western Blot/IFA). These are easy to perform, and are inexpensive. There is a clinic version of these tests, and a home testing version as well. There is also an antibody test that uses saliva, and another one that uses urine (however the urine test is not diagnostic for HIV by itself...it must be used with blood tests to diagnose HIV). All of the antibody tests are subject to the 6 month window period for the most accurate test result.

There are also PCR tests that can be used for diagnosis, but these tests are much more difficult to perform, and much more expensive than antibody tests. There are also p-24 antigen tests, but these must be used alongside other tests for a diagnosis of HIV. These tests cannot be used alone to diagnose HIV. There are also viral culture tests, but these tests may not always pick up an infection, and can literally take weeks to perform.

Throughout my answers on this website, are more detailed descriptions of the antibody tests, the PCR tests and the p-24 antigen tests. However for routine screening for HIV, the antibody tests are the tests usually used.

2) Why has the term AIDS-related conditions or ARC been abandoned?

This term got abandoned several years ago, since there was never a good definition of ARC (AIDS Related Complex). There was too much confusion as to what ARC really described. Therefore, the term was thrown out, and we now simply describe the condition as being HIV positive and symptomatic (but not meeting the case definition of full-blown AIDS).

3).....can we concluded that HIV was present in America as early as 1970 if not earlier?

All research data indicate that HIV entered the United States around 1977. There is no indication that HIV was in the USA before this. However, HIV is believed to have been in Africa since the late 1950's to early 1960's.

4) If the HIV reproduces itself only in our white blood cells, is it not hypothetically possible that temporarily suppressing the production of white blood cells might actually halt viral replication?

There is no way we could completely suppress the entire immune system. This virus has also been found to infect cells outside the immune system, including cells in the brain. Also suppressing the immune system would not stop the virus, since the virus could remain in immune cells that are not actively replicating. It is impossible to remove all the white blood cells in the body.

5) ....documented cases of individuals who have tested seropositive for HIV antibodies, but have consistently tested negative for the virus itself- suggesting that these indiviuals might have sucessfully eliminated the virus from their bodies.

There have been EXTREMELY rare (EXTREMELY unusual) cases of persons who apparently had HIV, but somehow overcame the infection. We do not know how or why this has occurred. We do not know if these persons had perhaps a nonvirulent strain of the virus, or if the person had some aspect of their immune system that overcame the virus. We just don't know at this point. We just know that on EXTREMELY rare occasions, there have been cases of people who somehow were apparently no longer infected with HIV. It's one of the mysteries of medicine that occur from time to time. Hopefully, by studying these people, we may have further clues how to treat HIV infection.

If you have any further questions, please feel free to contact the Centers for Disease Control at 1.800.232.4636 (Nationwide).



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