I've been HIV+ for over 24 years. A long time ago, my doc told me that upon initial infection with HIV, it pokes "holes" in your immune system that are permanent (presumably). He used an analogy like: if you remove the letter Z from the alphabet, you can't spell Zebra any longer, but you can describe it.

My CD4's are really good now (800-1200ish)... but I have noticed that over the years when I do get an infection (sinus, cold etc) it will linger until I get treatment (usually antibiotic). I've often wondered if this "hole" theory plays a role in this, or if my immune system is categorizing lesser infections accordingly because it "knows" something much worse is lurking?

If you do get "holes" in your immune system, later after your viral load is under control (mine has been for years, undetectable) -- can you patch those holes with immunization?

Can you elaborate on this.

Thanks.

Immunizations are generally effective and recommended for HIV+ patients with good CD4 counts (>> 200-350). The long term outcome in HIV + patients on treatment with a good CD4 count (ie > 500) is generally excellent so the extent of and consequences of any remaining "holes" in the immune system due to long standing HIV Infection are unclear and under intense study. KH