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Undetectable Viral load?
Aug 29, 2005

Dr.,

I am a 30 year old female who got infected by HIV-1 a year back. My antibody ELISA test is positive but when i checked my viral load recently, it said undetectable in extra sensitive RNA PCR test, which could detect virus as low as 20 copies per ml. Is it possible for me to stay undetectable i.e. less than 20 copies per ml without medicines even after one year of infection? Also i had unprotected sex with my other boyfriend who is HIV negative. I was bleeding due to my cycles when we had unprotected sex. After having 3 to 4 times sex with him, out of guilt i confessed to him that i was HIV +. He got himself checked twice with qualitative DNA & RNA PCR for HIV after a month and was found HIV undetectable. Later after 3 months his ELISA was negative. But after 4 and half months he had acute viral infection of some kind as his platelets and wbc went too low and was vomiting, high fever & dehydrated. He recovered in 3-4 days and got himself checked with qualitative PCR which was negative and Duo ELISA was also negative. His repeated ELISA testing at 7 months was also negative. I am scared that he might be detected positive after a year or so as my viral load being undetectable at this stage means that i have HIV which mutates too slow & thus does not produce enough virus to be detected in PCR and maybe such kind of virus maybe taking too long to produce antibodies in a human. IS IT POSSIBLE? If my boyfriend is indeed HIV negative now, is it because he is circumcised and that may have saved him from my infection. PLEASE ITS SOMETHING I NEED TO KNOW TO AVOID SUCH REPEATED SITUATIONS WITH ANY ONE ELSE. I made a mistake because i truly love him. PLEASE ANSWER!!!

Response from Dr. Luzuriaga

How was HIV infection documented? You don't mention what kind of confirmatory test was done after the positive ELISA. If you had antibody or nucleic acid (DNA) testing that confirmed infection, then you are one of a fortunate few that can control viral replication without therapy. This probably lowers but does not eliminate your infectiousness to others and you should definitely use safe sex to reduce the risk of transmission (See the Safe sex Forum on this web site). If ELISA testing on your boyfriend was negative at 7 months without further exposure, he is probably uninfected.


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