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Author Topic: Can Elite Controllers Be Elisa HIV NEG?  (Read 3193 times)

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Offline MitchMiller

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Can Elite Controllers Be Elisa HIV NEG?
« on: January 05, 2009, 01:09:23 AM »
Met a guy at a party that claims he was infected for four years with HIV and tested HIV neg the entire time, but suffered from night sweats.  Eventually he tested POZ and his viral load was undetectable w/Tcells over 1000. 

I read a lot of HIV news and I've never heard of this and am wondering if anyone else has. ??? 

I often wondered if I was infected, yet still testing HIV- after having unsafe sex (circa '81-'82) multiple times w/a partner that died of HIV infection about six years later (although his status was unknown at the time we were together).  In '82-'83 I got walking pneumonia for two - three months... and then had night sweats for two or three years... totally soaking the bed to the point where I would sometimes have to get up and turn the mattress... all the time testing neg.   In '94-'95 I had a full physical and doc said my white blood cell count was mysteriously high. 

I know exactly when I was infected (the second time ?) and was at 450 TCells (still hiv neg) at time of sero-conversion flu.  11 months later testing HIV+ and Tcells were at 112 and dropping 30/month at that point.  So I have always wondered if I was super infected causing the original virus to resurface and contribute to the rapid progression to AIDS.  I've read documented accounts of people who were HIV+, controlling the virus, but after superinfection, lost all control and experienced rapid TCell loss.

Offline Ann

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #1 on: January 05, 2009, 02:28:03 AM »
Mitch,

Even Elite controllers will test positive on an ELISA test within six week of infection. Antibodies (what an ELISA looks for) are produced no matter what.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline hotpuppy

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #2 on: January 05, 2009, 10:42:58 AM »
  I've read documented accounts of people who were HIV+, controlling the virus, but after superinfection, lost all control and experienced rapid TCell loss.

Could you share where you found these documented accounts?  According to what I read on the CDC's pages there are 16 confirmed cases.  This is a topic of ongoing interest.  For some reason, I decided that 16 cases out of 30 million+ cases of HIV was statistically insignificant.  Of course, if you are one of the 16 than it's not statistically insignificant..... just from a risk analysis standpoint it's a small number.  To put it in perspective, you have a higher chance of being murdered.

Anyhow, I would also keep in mind that many people do not understand ELISA, Western Blot, and PCR RNA testing.  When I tested positive I had an indeterminate western blot.  I did alot of reading and learned alot.  I also became aware that "authorities" were often working on 2+ year old information.  So if someone I met at a party made that claim I would write it off as "fluff."  I would probably do a brief spot check of their general knowledge and see if they were hooked on other myths as well.

There are a couple of recurring themes that I repeatedly run across in the gay community regarding HIV.

1. The cure myth:  This is really just good old-fashioned denial.  It usually surfaces in the form of someone believing that something or someone can cure them of HIV. 
2. The not my fault myth:  This is a touchy one.  However, it seems like 25% of the men I meet claim to have been raped.  I'm sure it does happen.  But that much?  c'mon.  Just ask me to feel sorry for you, it's easier.  NOTE: I'm not denying that some people have had rape happen to them, I think it's an awful crime.  I just think it's suspicious that so many gay men claim to have been raped.  On a related note, is it really rape when they are tweaking out of their mind and climb into the sling at the baths and ask 10 guys to fuck them bare? 
3. The morality myth:  This one is usually connected to religion.  My favorite incident is someone who goes to church twice a week, drinks like a fish, and looks down on the rest of us for our evil ways.  ROFL.  All I can say here is, beware of mirrored floor tile dearie.
4. The control myth:  This one is normally connected to STD messaging and seeks to encourage or discourage specific types of behavior with FUD as the basis.  FUD is Fear, Uncertainty, and Doubt.  A common form is related to the threat of Superinfection and the mandate to play safe at all times with all people.  Which is essentially the zero risk myth.  I think there are really hidden agendas at work here and I really prefer people to call a spade a spade instead of a manually operated eco-powered excavation and earth moving system workload device fashioned with 86% post consumer content (aka a human with a shovel made of steel [most steel is recycled]).
Don't obsess over the wrong things.  Life isn't about your numbers, it isn't about this forum, it isn't about someone's opinion.  It's about getting out there and enjoying it.   I am a person with HIV - not the other way around.

Offline RapidRod

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #3 on: January 05, 2009, 10:54:00 AM »
Having been a LTNP for 21 years. I can tell you that you will always test positive. Your CD4 will be within the normal range. Mine were always in the 1400s. As for the viral load it went from undectable to no more than 4000 back and forth.  So as Ann has rightfully said, your antibody test will always show positive.

Offline mecch

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #4 on: January 05, 2009, 06:00:45 PM »
Well now that we are on the topic, I have a question for Rapid or anyreader.  Is there a common mechanism that switches a person from being a LTNP to a progressor? I mean, if you know or care to speculate about your personal experience, what makes you suddenly loose that great fighting ability and immune equilibrium.  Or, perhaps give me a link to a source that explains this. Thanks.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline RapidRod

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #5 on: January 05, 2009, 06:26:16 PM »
They don't know what causes the CD4 to crash in such a rapid manner as with mine.

Offline mecch

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #6 on: January 05, 2009, 06:34:02 PM »
Figures. Ah the endless mysteries.  Well, at least you had all those good years, and I hope you find that balance again soon, cause I know a few weeks back you announced a setback so I wish you well.


“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline RapidRod

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #7 on: January 05, 2009, 06:42:04 PM »
Oh yeah the HISTO rared it's ugly had. Just went today to get a refill for the meds and it drop almost 1400 dollars, it was only 3096.00 today for a months supply. Other than that I'm doing pretty good.

Offline mecch

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #8 on: January 05, 2009, 06:42:35 PM »
I would probably do a brief spot check of their general knowledge and see if they were hooked on other myths as well.
Your thread on bug chasers got a lot of good discussion. Sounds like you might have some more ideas that you could post as separate threads. Nothing academic or intellectual has gotten much attention on Off topics for a few days. Why don't you post up something about your HIV Myths.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline mecch

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #9 on: January 05, 2009, 06:46:40 PM »
Remember the South Park cure for AIDS is liquified cash. Its too true.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline MitchMiller

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #10 on: January 06, 2009, 12:16:28 AM »
I did a few google searches and found this report which is basically what I was talking about.  Because genetics play a major role in the ability of the body to control HIV, some strains of the virus may be more lethal than others, on an individual basis... based on the genetic makeup of the subject.   Therefore, one who may be considered a LTNP may find that their control of HIV is not universal to all strains of the virus.

Here's an article published on TheBody.com that mentions a documented case in the middle of the article (in bold).  I also remember one where the guy was never on HIV meds but after superinfection occurred while he was on vacation, he quickly lost all viral control.  Seems logical to me that this sort of thing is an expected possibility.


http://www.thebody.com/content/treat/art5042.html

Re-infection is a term used to describe a new or secondary infection by a virus that has already infected a person. In most viral diseases, re-infection with the same virus doesn’t occur because once the immune system conquers the original viral infection, it creates immunity against that virus. Re-infection occurs almost constantly, however, in some types of infection, such as the cold or flu viruses, because each new version of those new viruses is substantially different from the last. This is why a person may develop immunity to the flu strain that is common in one year, but still be at risk from the strain that becomes dominant the next year.

The question of re-infection with HIV has long been debated. There is no theoretical reason to think re-infection isn’t possible, since the immune system never fully conquers the initial HIV infection. Still, many people, including many physicians, clung to the hope that re-infection with HIV either does not happen or that it only happens rarely. This view is the basis of the belief held by some HIV-positive people that having sex or sharing needles with another HIV-infected person poses little or no risks. Many if not most virologists, however, have long believed that re-infection is both possible and perhaps even likely. What is not known are the individual short- and long-term clinical consequences (which may vary from person to person for wholly unknown reasons).

For many years, there were no clear cases of re-infection presented at scientific conferences, but this did not mean such re-infection wasn’t occurring. Instead, we know that finding and documenting cases of re-infection is extraordinarily difficult, if for no other reason than that no structured program has looked for them. Finding a case of re-infection has largely been a matter of chance. Yet, several observations over the years support the notion that re-infection is possible, including observations of sex workers in Africa infected with several different recombined “clades” of HIV as well as detailed genetic analysis of a few people’s virus suggesting that re-infection was possible. This research is very difficult to conduct. Perhaps the only simple example of re-infection is in western Africa, where people are routinely found who carry both HIV-1 and HIV-2. At the very least, this proves that having HIV-1 does not protect a person from infection with HIV-2.

Recently, there has been considerable media attention about a few well documented cases of suspected re-infection with two versions of HIV-1. The most interesting case, presented by Dr. Bruce Walker, was the result of an almost accidental observation. While researching the effects of Structured Treatment Interruption (STI) in some newly infected volunteers, Walker’s team was intrigued by one particular case in which the volunteer responded well to two initial cycles of STI. After each, the person’s viral load remained undetectable for several months without treatment. Shortly after a third STI, however, the viral load remained low for only a brief period and then suddenly soared upward. The team wondered what made things different this time? After conducting extensive genetic analysis, they found their answer: the volunteer had become infected with a second, slightly different strain of HIV. Most striking, and discouraging, was that the genetic makeup of the new infection differed by only 12% compared to the original infection. Despite this small difference, the second infection had completely escaped control by the immune system, breaking through the suppression achieved against the original virus. This discovery, while important enough in regards to re-infection, also had discouraging implications for vaccine development, suggesting that as little as 12% variation between viruses might be enough to make a vaccine fail.

Several questions remain in regards to re-infection. Will re-infection lead to more rapid disease progression? Will re-infection with HIV result in transmission/acquisition of drug-resistant HIV that will limit a persons’ anti-HIV treatment options? Both of these concerns are theoretically possible, and both have now been demonstrated in case studies. Currently there is not a large amount of data to assess the actual risk to the individual. Although only a little data currently exists and it is extremely difficult to gather more, it does not lessen the real potential for re-infection or its consequences.

There are several reasons why people living with HIV would want to maintain safer sex activities. While the clinical implications of re-infection remain unknown (and will likely be unknown for many years to come), there is some evidence of harm and no evidence of harmlessness. We also know for certain that safer sex does protect against many blood-borne infections that are major causes of life-threatening diseases and death in people with HIV. These likely include CMV, some forms of hepatitis virus, genital herpes, possibly the JC virus (cause of a particularly destructive condition known as Pml), to name a few.

Ultimately people living with HIV need to consider this information and make informed decisions about safer sex for themselves. In the early 1980s many did not want to believe that HIV was caused by unsafe sex. Many people have dearly paid the price for that belief. The optimal outcome here is for people not to fight against data and shy away from acknowledging the potential consequences of re-infection. Some people will come to a conclusion that it’s better to be safe than sorry. Others will choose the risk of being sorry rather than safe and will continue to participate in unsafe sex with positive partners. What matters most is that people make a conscious decision based on the available information.

Offline MitchMiller

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #11 on: January 06, 2009, 12:30:50 AM »
I found an article on the subject of HIV infection and no antibodies.  This article sites documented cases for up to three years.  Note this article is 20 years old.  I don't know if the Elisa test today is more sensitive than it was in 1989.

http://findarticles.com/p/articles/mi_m1200/is_n22_v135/ai_7344066

I subsequently found a second article here that looks like the original researchers were unable to reproduce their results.  The leading researcher, now deceased, stood by his original research... but it does look like they probably made a mistake somewhere along the way.... maybe.

http://query.nytimes.com/gst/fullpage.html?res=9D0CE0DE133DF936A35752C1A967958260&sec=health&spon=&pagewanted=all

Because this is old news, just thought I would add it to the discussion for those that might want to do more research.
« Last Edit: January 06, 2009, 12:43:43 AM by MitchMiller »

Offline md

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #12 on: January 06, 2009, 03:05:39 AM »
Met a guy at a party that claims he was infected for four years with HIV and tested HIV neg the entire time, but suffered from night sweats.  Eventually he tested POZ and his viral load was undetectable w/Tcells over 1000.

Perhaps I am missing something here, but how precisely did he "know" that he was infected all the time that he was testing negative. If he believes that he was HIV+ just because he had some night sweats then he is an idiot.

Seems much more likely that he was actually negative for those four years even though for some unknown reason he did not believe it but then he eventually got infected and tested positive.

Offline mecch

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #13 on: January 06, 2009, 03:41:37 AM »
Mitch, your original post has enough open endedness to warrant a few more precise threads.  The title seems to answerable, but the questions around reinfection not always answerable and often not related to the title.  (One could be HIV+ and eventually be reinfected, theorectically.  As in those sex workers in Africa.  Most info about reinfection is related to that, not the idea that a primo infection might be invisible for months or years.)

I think the title question needs more state of the art input in this thread, based on the current situation with P24 antigen tests, etc.  It seems to me in 2009 that HIV infection cannot go undetected by the most state of the art testing methods.

However, Ann says: "Antibodies (what an ELISA looks for) are produced no matter what" - but what if antibodies are NOT produced for quite some time?  (Is that possible?)  Does that mean P24 continues to be produced?

(Also, tangentially, I do believe I heard that HAART at acute infection very rarely but can produce antibody reversion - not a cured patient and not a Elite Controller, but a person infected with HIV, treated, and not "HIV+".)







 
« Last Edit: January 06, 2009, 03:45:11 AM by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Dachshund

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #14 on: January 06, 2009, 07:37:21 AM »
Nothing academic or intellectual has gotten much attention on Off topics for a few days.

Or anywhere else for that matter. The thread on bug chasers a prime example.

Offline hotpuppy

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #15 on: January 06, 2009, 11:07:02 AM »
Nothing academic or intellectual has gotten much attention on Off topics for a few days.

Or anywhere else for that matter. The thread on bug chasers a prime example.

I think it was a legitemate question.  Learning from one another is one of the best traits humans exhibit. 

Don't obsess over the wrong things.  Life isn't about your numbers, it isn't about this forum, it isn't about someone's opinion.  It's about getting out there and enjoying it.   I am a person with HIV - not the other way around.

Offline hotpuppy

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #16 on: January 06, 2009, 11:14:27 AM »
They don't know what causes the CD4 to crash in such a rapid manner as with mine.

I would suggest looking into tropism.  I have to think for a second on what I'm allowed to say.  As you may know I'm in a drug study for an entry inhibitor.  Okay, when I was evaluating the study there was a good bit of discussion about the potential consequences.  I think this is public information, so it's okay to share.  One of the risks of taking an entry inhibitor for R5 is that it might encourage a shift to the X4 tropism.  The X4 tropism is associated with rapid CD4 decline and advanced HIV.  They aren't quite sure what causes the shift, just that it does happen.   

I would look here first as it's a good suspect.  Approximately 60 to 70% of new infections are R5 tropic (meaning that the HIV only uses R5). 

The gist of what my study doc said was that they think people are primarily infected with R5 and then at some point, for some reason it shifts to X4 and things go downhill.
Don't obsess over the wrong things.  Life isn't about your numbers, it isn't about this forum, it isn't about someone's opinion.  It's about getting out there and enjoying it.   I am a person with HIV - not the other way around.

Offline RapidRod

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #17 on: January 06, 2009, 11:28:14 AM »
hotpuppy, I have adjusted well to my situation. I consider myself lucky that I went that long without the need of medications. I don't even think about it or why. There is nothing I nor anyone can do about it so I just go on living my life.

Offline mecch

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Re: Can Elite Controllers Be Elisa HIV NEG?
« Reply #18 on: January 06, 2009, 05:49:48 PM »
Nothing academic or intellectual has gotten much attention on Off topics for a few days.

Or anywhere else for that matter. The thread on bug chasers a prime example.

I thought the bug chasers thread was interesting.
“From each, according to his ability; to each, according to his need” 1875 K Marx

 


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