HIV Transmission and Testing: Key Questions Answered

Q: HIV Transmission and Testing: Key Questions Answered

Anonymous： Hello, medicine is very unscientific, and I emphasize this once again. <br>What I'm saying is that the situation you described cannot be experimentally verified to determine whether a small amount of viral invasion will lead to illness, or if the mere presence of the v

Two types of questions?

First of all, thank you for the detailed response from the doctor.
I have two remaining questions.
Here is a question I asked previously: Does this mean that if a person is exposed to the HIV virus through a transmissible route, but the concentration of the virus is not high enough to reach a pathogenic level, the body's white blood cells, antibodies, and immune system can completely eliminate it, preventing illness or latent infection? Is that correct?
I still have some confusion: I have seen reports of that particular case (is he the only one in the world or are there very few, perhaps less than 100?).
So, the doctor mentioned that once HIV enters the body, almost everyone, except for a very small number of cases, will either become ill or have a latent infection and be a source of transmission, right?
Doctor, aside from those rare exceptions, does it mean that almost everyone who comes into contact with HIV through a transmissible route (mucous membranes or wounds...) will inevitably have the virus enter their body, regardless of the concentration of the virus or the strength of the immune system? Or is it that coming into contact with HIV through a transmissible route and being infected by the virus are different, influenced by factors such as the concentration of the virus, the strength of the immune response, or other factors that determine whether infection occurs?
Lastly, as a side question, regarding HIV testing, if a person has been infected with HIV, whether they are symptomatic, asymptomatic, or in a latent state, will they definitely test positive at three months post-exposure (if I remember correctly, three months is the time frame set by hospitals for testing)? Would waiting a little longer, like three and a half or four months, yield more accurate results? Thank you very much for the doctor's answers!

Niming, 20~29 year old female. Ask Date: 2008/08/10

Dr. Xu Weikai reply Urology

Anonymous: Hello, medicine is very unscientific, and I emphasize this once again.
What I'm saying is that the situation you described cannot be experimentally verified to determine whether a small amount of viral invasion will lead to illness, or if the mere presence of the virus, regardless of quantity, will cause disease; this point remains uncertain in medicine.
However, the few individuals with strong immunity that I mentioned have been confirmed to be infected, as evidenced by blood tests showing signs of infection.
Yet, after some time, without any treatment, no traces of the virus can be found.
Follow-up examinations also fail to detect the virus again.
Additionally, if there is no viral response after more than three months of testing, it should indicate that there is no infection.
Of course, the later the test is conducted, the higher the accuracy.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Department of Urology, Taitung Hospital, Ministry of Health and Welfare, Concerned about your health, Director Hsu Wei-Kai.

Reply Date: 2008/08/10

More Info

Understanding HIV transmission and testing is crucial for anyone concerned about their health. The questions you've raised touch on several important aspects of HIV, including the nature of transmission, the body's immune response, and the reliability of testing.

Firstly, regarding the transmission of HIV, it is essential to understand that HIV is primarily transmitted through specific routes: unprotected sexual contact, sharing needles, and from mother to child during childbirth or breastfeeding. When HIV enters the body, it targets the immune system, specifically CD4 T cells, which are crucial for fighting infections. If the concentration of the virus is low, there is a possibility that the immune system can control and eliminate the virus before it establishes an infection. However, this is not the norm. Most individuals who are exposed to HIV through a high-risk route will become infected, regardless of their immune system's strength or the initial viral load.

The concept of "acute HIV infection" is also significant. This phase occurs shortly after the virus enters the body, often accompanied by flu-like symptoms. During this time, the virus replicates rapidly, and the body begins to produce antibodies against it. However, it can take time—typically between 2 to 12 weeks, and sometimes up to 6 months—for these antibodies to reach detectable levels in standard tests. This period is known as the "window period." Therefore, if someone is tested too soon after exposure, they may receive a false negative result.

Regarding your question about the possibility of being exposed to HIV without becoming infected, it is important to note that while there are rare cases of individuals who have been exposed to HIV and did not become infected (often referred to as "elite controllers"), these are exceptions rather than the rule. The vast majority of people who are exposed to HIV will become infected if they do not take preventive measures, such as post-exposure prophylaxis (PEP) or pre-exposure prophylaxis (PrEP).

Now, concerning HIV testing, the standard recommendation is to get tested at least three months after potential exposure. This timeframe allows for the antibodies to develop to a level that can be detected by most tests. If you test negative at three months, it is generally considered conclusive. However, testing at six months can provide additional reassurance, especially if there were any concerns about the accuracy of the initial test or if the exposure was particularly high-risk.

In summary, while the body has mechanisms to fight off infections, HIV is particularly adept at evading the immune system. Most individuals will become infected if exposed through high-risk routes. Testing is crucial, and following the recommended timelines ensures the most accurate results. If you have any concerns about potential exposure or testing, it is always best to consult with a healthcare provider who can offer personalized advice and support.

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