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cross infection between 2 POZ guys

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An interesting subject came up at a POZ group that I belong to and I'd like to hear what the community here has to say about the topic.

What are the risks of cross-infecting a POZ partner with a different strain of the virus through unprotected anal sex?- oral sex? If you're both undetectable? if you're both on Meds?
Does having one strain in your system 'block out' another strain from entering?
Is there a 'dominant' strain that will take over if the weaker strain is present?
Are there studies on the subject?

I know there are a bunch of questions here, and I apologize for that. The group discussion seemed to have a wide variety of opinions, so I was wondering what the HIV community/ medical professionals now believe on the subject.

Thanks for your insight!

I would think if it was a concern (even with people not on meds) that there would be a major problem that we would have heard about.  For now it doesn't seem to be an issue to worry yourself about.

As ever, transmission depends on quality, quantity and opportunity...

Both on meds the viral load is so low this is really a non-issue, there ain't any, whatever type of sex. Whatever meds.

Off meds, the risk increases as the two viral types diverge. The same virus, well so what if you get a bit more of the same virus, different virus, possibly might be interesting.

It's an outside chance anyway, there are perhaps 2 dozen document cases of clinical importance in 40 million cases of HIV.

Different people will reach different conclusions on this point. there isn't a right answer. It's what you feel comfortable with.

- matt

Looking from a good sense point of view

 Undetectable viral load in the blood doesn't mean Undetectable viral load in Semen or gut mucosal. So virus could still be transmit via unprotected anal sex.

Oral sex is a very low risk behavior to transmit virus in the first place. Saliva kill HIV unless you clearly have visible broken skin with blood in your mouth or penis while performing oral sex. the risk is very very low but no body can says that it impossible.

The mechanism that HIV enter the body, is still there when you are positive, so yes you can get super infection. The problem is going to be if the new virus is resistance to the drug that you are taking for you own virus, then you will end up with having Drug resistance HIV and possible developing Muti drug resistance HIV.

Several research have been made on HIV genetic, i'm not sure but you can search around. Some HIV mutation that cause drug resistance can make the virus less infectious or progress slower(replicated slower) it also goes the other way. So yes, in the presence of several strain of HIV virus the virus that able to replicate faster and able to evade your body immune system better will become the dominate strain in your body. In the situation where is ARV involve the strain the have drug resistance will quickly take over the body while the other strain will be stop by ARV.
From this, that why you need HAART, mono therapy put selective pressure in the virus population and soon it will become resistance. 3 drug combo from at least 2 difference class is effective to stop that from happening in the first place.

HIV virus is also part of Mother nature as well, so i don't see why it will get except from the law of Nature.The strongest virus will survive and procreate. The weaker one will vanish. That why you see report like, rising drug resistance on HIVer in the future, due to treatment expansion. Tranmission of HIV drug resistance is increasing, because Drug resistance virus will be able to replicate in the present of ARV and that mean higher viral load. Higher viral load translate to higher chance of transmission!

A couple of questions:

--- Quote --- Undetectable viral load in the blood doesn't mean Undetectable viral load in Semen or gut mucosal. So virus could still be transmit via unprotected anal sex.

--- End quote ---

I recall reading about the detectable levels of HIV found in the semen of patients who had an otherwise UD VL, but not the gut mucousal. Was this in the same study? I would appreciate the source.

Also, while this translates to initial infection, is there any indication that it translates to re-infection? As there have been only two dozen or so confirmed cases, I would assume that the circumstances of those "cross-infections" have been parsed rather thoroughly. Could you source this information as well?



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