Queries about non-progressing

[wambb]

It is known that some people won`t be affected by the HIV virus - at least they don`t go on to develop classic HIV. They may be affected in some way.

Now if such a person is exposed to the HIV virus, and they get "infected" ( ie - it gets into their bloodstream ), but don`t go on to develop HIV - what happens if they then have the standard HIV tests.

Do they develop either antibodies or antigens which would show in an HIV test ?

( I believe that these are the two things that current standard HIV tests look for. )

Or do they not have either of these, or have them in sufficient quantities to show in an HIV test.

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Now repeat the above questions for normal people who get "infected" by the HIV virus, but take some form of Post Exposure Prophylaxis, or something which "boosts" their immune system ( in particular their CD4 count ), so they don`t go on to develop HIV - do they develop either antibodies or antigens which would show in an HIV test ?

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Does anyone know anything about this ?

[rawTOP]

I think you're confusing a few terms.

For starters regular people can be exposed to HIV and not become HIV positive. It typically takes quite a few exposures to become poz. Back before ARVs existed it was thought to be 100 exposures (on average) - though some people get it on the first exposure and others get it on the 1000th exposure. A lot depends on the viral load of the poz guy they're having sex with. BTW, You were confusing the term exposure with infection. Exposure means you come in contact with HIV, infection means you become HIV positive.

Some people are immune to HIV (about 1% of people of Northern European ancestry - thanks to their ancestors being exposed to Small Pox and surviving). It means when HIV enters their body it can't establish a foothold. (Actually, there are a few strains of HIV that can infect these people but they're rare). In that case there's no infection - just exposure.

Other people are resistant to HIV (about 10% of people of Northern European ancestry). That means when HIV enters their body it finds it difficult to establish a foothold - but not impossible. These people are less likely to become poz than a regular person.

Taking PrEP is somewhat similar to being resistant to HIV. PrEP makes it difficult for infection to happen by blocking the paths HIV uses to establish itself and infect the person.

And yet another group are considered to be HIV controllers. That means they have no protection from infection, but once infected their body can naturally keep the viral load relatively low without meds. Their viral load isn't undetectable, but even their lower viral load they have does have benefits. They may choose to go on meds later and if they don't go on meds at all they will survive much longer than other people who don't go on meds.

As far as antibodies - they only exist in people who are infected. I know that's different than other diseases where antibodies can show that you successfully fought off the infection, but it's how it is with HIV. People who are immune or resistant do not have antibodies unless they become poz. Being on PrEP does not give you antibodies. Nor does PEP give you anti-bodies. The purpose of PrEP and PEP is to prevent infection, not fight infection once it's happened. There are vaccine trials where they cripple HIV viruses and put them into your body to try to cause infection by a form of HIV that can't hurt you. Those people do get antibodies, but that's never been done widely since all the vaccine trials to date have failed (rather miserably).

Genetic tests (such as those done by 23AndMe) can tell you if you're immune, resistant or a controller (plus a whole lot more).

[wambb]

Hi

Thanks for all that - if I follow it all correctly, it means that if you have an HIV test, and the result is negative - then it means there are four possibilities -

- you haven`t been exposed to HIV

- you may have been exposed, but you haven`t become infected yet

- you may have been exposed, but are one of the 1% who are immune

- you may have been exposed, but are one of the 10% who are resistant so haven`t been infected yet

and more importantly, you can`t tell which is the case from the negative result.

If the test result comes back positive, you may or may not be a controller.

Thanks for the info.

[Guest JizzDumpWI]

True, but you could for a relatively small amount get a genetic profile done by 23andme and learn a lot about yourself; including whether you are "immune", resistant (me); and whether or not you are a controller (me). There is a huge amount of interesting information beyond how HIV might behave with you. I'm sure glad I did it.