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WHAT'S GOING ON HERE?
Sep 29, 2000

DEAR DR. I thought the antibody test were very reliable. So, what is this with what I read in CCN website today. It reads: "A key, doctors said, is to begin treatment early -- perhaps even before a patient tests HIV positive by conventional means. " 'In November 1996, Mike Burns thought he had the flu, but his doctors suspected HIV. They were right. The level of the virus in his blood was extremely high,'said Dr. Eric Rosenberg, an AIDS researcher at Massachusetts General Hospital in Boston. 'And when we tested him for the standard HIV antibody test, that was negative.' " Should I start worrying now or what? I tested negative three times on the Elisa test. I can still have the disease? Should get a T-cell count and Viral load test? Please help us out here, because I think this is an important issue. Thanks

Response from Mr. Kull

It's hard for me to answer your question sufficiently since the excerpt you quote is out of context. However, I have a feeling that you might be misunderstanding what is actually being said. Currently, there is speculation that treating HIV infection as early as possible (before seroconversion) could lower the viral set-point throughout infection. This means that with early treatment a person's immune system might maintain a lower viral load over the years than if they hadn't received early treatment. It seems that the situation with Mike Burns illustrates a very early detection on the doctors' part.

Shortly after a person is infected with HIV, the virus begins replicating wildly until the immune system manages to slow down replication. During this period, a person would seroconvert (develop antibodies), usually around three weeks after infection. The doctors probably performed a viral load test on this guy because they strongly suspected HIV infection and assumed that he had not produced enough antibodies to be detected by the standard antibody test. This will be a helpful tool in the future to begin treatment as early as possible.

Again, be careful of what you read in the press; it's often subject to misinterpretation. The antibody test is still golden.

RMK



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