Dear Eric,

i'm referring to this previous question & answer. you indicated that after testing hiv+ thru' ELISA/WB antibodies test, VL proves that there's virus present. here's my situation: 36yr old female. tested positive 2yrs ago. 2 ELIZA/WB. my VL was undetectable upto this day, <50. no medication. CD4 range 600-950. i visit my doctor every 3mths for CD4/VL count as well as other tests. all tests neg-. i.e hep A,B,C. neg-TB, liver & kidney okey, CD% good e.t.c. healthy in other words. my hubby of 4yrs been negative. i never 'cheated' on him since we met 5yrs ago. so i must have been exposed before, i don't know how long ago. last 2 boyfriends, negative. condom have broken afew times during intercourse, thanks God my hubby still negative. questions: is this normal diagnosis? do you have frequent similar cases? where would the virus be hiding? what is likely to keep it at bay? what are the scientific findings towards such individuals? pls comment on this case. pls bear with me for too many questions. thank you for your continued support.

concerned, NYC

Hi NYC, Based upon what you have written and assuming your HIV-1 antibody test is fully positive by Western blot and there have been no mistakes, I would assume that you are infected. With repeatedly undetectable viral loads and normal CD4 cells you may be one of the relatively rare that has done an outstanding job controlling HIV without therapy. There are select other reasons why this could happen because of assay issues, but these would seem less likely. It is generally thought that it is the immune system that is responsible for controlling the virus in situations like this. There may also be other factors contributing to your success.

The fact that virus is not detected in blood does not mean that it is not present in the body. Presumably HIV persists in various tissues throughout the body including the lymph nodes. At this point I would just discuss these issues with your provider, make sure that all of the tests for HIV antibodies are correctly interpretted, and if they are keep doing what your are doing because it seems to be working.

Best, Eric