What time after infection referred to in the context of “early treatment”?
Hello. The research I have been reading suggests early treatment after HIV infection can be successful in eliminating the virus.
My question is what is considered “early” treatment? Is this within hours? or within days or weeks? I began my treatment 3 months after infection. My CD4 never dropped below 500 and my initial VL was 10,000. Two years later on same regimen my CD4 count is 1200 and I have an undetectable VL.
How do we ever know if by chance the virus has indeed been eliminated? Discontinuing therapy is too risky. I went to a clinic for a swab test and it came back negative. Can you help answer my questions?
Thanks for your questions, some of which I can help with but some of which no-one can answer yet. This is because you are asking about ongoing research that is only being looked at for the first time.
You first question about defining early treatment depends on the context of the research.
In general though, early HIV infection, sometimes called primary infection, refers to the first six months after infection. This is the definition in several studies that a re looking at differences in immune responses from starting early treatment compared to starting in chronic infection.
This is the window period, for example, for people with recent infection to be included in the UK HIV Seroconverters Register. It is also the approximate window period for the tests that are used to determine recent infection (called variously, a detuned CD4 test, an avidity test, STARHS or RITA tests). These tests are based more on immune responses than time, so although the average is about six months, some people may have similar immune responses earlier or later.
However, the VISCONTI cohort who have since stopped treatment without viral load, were treated within the first eight months.
Other researchers think that there might be a difference between starting at within three months compared to six months. Others think there may be a difference between starting within one month compared to three months.
I think you are right to follow the research, and to not be in any hurry to want to stop treatment.
You have had a great response so far, and at some time in the future, you might find that your decision to start early open up options that most of us missed.
I can’t explain the negative swab result without knowing the details of the test. Theoretically, anyone who clears HIV in the future is likely to still test HIV positive on an antibody test.