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What case reports
Jul 14, 2006

Hi, I would like to ask a brief question of your answer to a previous question in this board. You cite in the answer: "a. Over 99.5% of people will have acquired anti-HIV antibodies (and have a positive standard test) within 6 months of an exposure. For some people who received post-exposure prophylaxis, some feel testing should be done out to 12 months, as the treatment may delay seroconversion. There are a number of case reports of people who never become positive. If there is some concern of HIV infection, other tests (CD4 counts and viral load) should be done to figure it out." link here to the original post:

My question concers this "case reports" which you say have developed antibodies to HIV. Do you mean by these case reports certain articles in the internet that describe few African persons that were infected with an atypical HIV strain and had impaired immune systems (low CD4 count) that weren't able to develop antibodies ? HIV was detected by antigen capture in these reports.

Or do mean people in late stage of HIV disease, of whom there are numerous reports of not developing antibodies.

The reason I'm asking this is that your answer may trouble the Worried Well and frankly needs some clarification.

Thank you for your answer.

Response from Dr. Conway

I am referring to an exceedingly small number of individuals who are carrying HIV but do not have an antibody response to it that is detectable by conventional tests. This is a small group of people and the virus is always easily detected by conventional tests such as viral load assays.

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