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undetectable without medication
Nov 28, 2008

Hello, It's been 5 years now that I have been diagnosed HIV+, and yet I am not on medication. Weird enough my latest tests showed undetectable viral load and a CD4 of around 1,000 (both much improved results than previous tests) noting that I have not yet needed to start medication. The Dr. asked for re-testing my HIV status, just to be 100%sure, evidently it was positive. Is there any scientific explanation for this improvement?! does it signify anything?! Thanks

Response from Dr. McGowan

Dear Undetectable,

I am very glad that your viral level and CD4 count is so good. There are certain people called "long-term non-progressors" (about 2% of people with HIV) who can be infected for many years and have sustained high CD4 counts and low viral loads. There are various possible explanations for this including the activity of the CD8 (or suppressor) cells to keep the virus in check as well as the type and amount of co-receptors (usually CCR5) that are present on your CD4 cells. The virus has to attach to both the CD4 molecule and a co-receptor (usually CCR5) on the T cell surface to be able to infect the cell. Some people are born with mutated co-receptors that do not allow the virus to enter the cell efficiently (or are expressed at low levels). It is important to keep going for check-ups because sometimes the virus can adapt to your body's defense and start to grow at a higher rate. Also, you should still continue to practice safe sex so that the virus (even at low levels) may not spread. Just because your body has been able to keep things in check does not mean that your virus might not wreak havoc for someone else. The rise in CD4 counts can be part of the normal ebb and flow that is seen with measurements of CD4. Just keep on top of the trends rather than any one specific number. Good luck, I hope things remain stable for you.

Joe


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