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Hi. I Am A Pre-med Student Shadowing An Infectious Diseases
Question: Hi. I am a pre-med student shadowing an infectious diseases specialist. I have a question. I don’t want to seem dumb to the doctor I’m shadowing so I’m asking here. She specializes in HIV treatment. A 26 year old patient has been undetectable for two years Her viral levels are low and her CD4 count is high. However, she just admitted to the doctor that she hasn’t taken her HIV medicine in over 1.5 years. How is this possible? Is it possible that she had a false diagnosis of HIV or is it somehow possible that she was cured?
Brief Answer:
This could be possible.
Detailed Answer:
Hi,
Welcome to 'Ask A Doctor' service,
Thanks for posting your query.
People with HIV infection will have their manifestations usually (apart from acute infection) after 7-10 years or more. HIV after entering into the body establishes itself inside the CD4 cells and multiplies. In this process the T4 lymphocytes destroyed and the individual looses immunity to combat infections and vulnerable for infections. This could range from mild to severe according the immune status of the individual.
Body will try to combat the situation by producing more CD4 cells. In due course the efforts of the body lost and the virus took upper hand. This process may take up to 10 years or even more in some individuals. So there is no wonder that your patient's viral load remain low with a high CD4 count.
She would be infected within 5 years and not more than this.
Some people remain as long term non-progressor for years together.
I know a man with HIV infection remain symptom free for nearly 18 years and not on ART. He doesn't want to take ART. His wife is also a HIV positive women (He married a HIV positive widow) and is on ART.
Dr S.Murugan
This could be possible.
Detailed Answer:
Hi,
Welcome to 'Ask A Doctor' service,
Thanks for posting your query.
People with HIV infection will have their manifestations usually (apart from acute infection) after 7-10 years or more. HIV after entering into the body establishes itself inside the CD4 cells and multiplies. In this process the T4 lymphocytes destroyed and the individual looses immunity to combat infections and vulnerable for infections. This could range from mild to severe according the immune status of the individual.
Body will try to combat the situation by producing more CD4 cells. In due course the efforts of the body lost and the virus took upper hand. This process may take up to 10 years or even more in some individuals. So there is no wonder that your patient's viral load remain low with a high CD4 count.
She would be infected within 5 years and not more than this.
Some people remain as long term non-progressor for years together.
I know a man with HIV infection remain symptom free for nearly 18 years and not on ART. He doesn't want to take ART. His wife is also a HIV positive women (He married a HIV positive widow) and is on ART.
Dr S.Murugan
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Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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