Q and A

Question

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?

Answer

Hi

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.

 

5 comments

  1. Awintim

    Hiv Is More Of Emotional Than physical,If Something has to Hurt you so much it must come from humans not the devil, animal or a virus.
    I Hope you get well soon.
    Im about one month now since diagnosis I only know it gets beter but i don’t know it will ever go away or becomes something not hurting anymore.But Then If Its gets beter within a month,I can predict it will one day not bordering at all.

  2. Simon Collins

    Thanks, most people find it gets much easier with time. You have a lot going for you.

  3. Jake

    Thanks, Simon. Guess I’m always hoping that a mistake was made. But the good news is is that I am in phenomenal health physically. Just hoping that the emotional pain subsides. – Jake

  4. Simon Collins

    Hi Jake, I’m not sure what you are now asking. If it is about whether you are HIV positive, then your original positive test should have been confirmed with a second test. Usually this is done in the lab without you knowing it. Also, I assume you had a viral load test before starting treatment. This would also confirm your were positive.

  5. Jake

    Thank you for answering my original question above. I guess I am still hopeful that although I am still taking my medication faithfully, my health would be great without it. I called the clinic where I tested negative after my original positive reading two years before (I went with a friend and figured its free so why not give it a shot). They used the Oraquick test and the result was negative. I explained my situation to the counselor and she believed that my test should have read a positive reading if I did in fact have HIV. Two years ago when I was diagnosed I went directly to an HIV specialist. Began treatment that night three months after i was infected. I go see my doctor next week and would like to know your thoughts before I speak with the doctor. I am confused and dont know who to trust or believe. Thank you so much!

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