Reply #29: No, he wouldn't have antibodies.

[Liberal Veteran]

There's the rub.

HIV diagnosis is not as simple as say, a strep test. In the a strep test, a culture is done which determines you are infected with the bacteria.

Culturing HIV is a very costly and difficult process.

So you might ask, how is one diagnosed with HIV?

A person takes an HIV test which detect the presence of HIV specific antibodies in the blood. A positive test is confirmed with a western blot test. The former is much more prone to false results than the latter, but the latter is much more accurate, but complicated and thus not used as the primary test.

If both those tests are positive, you are usually told at that point that you have HIV.

So, that brings us to the next stage. This would viral load test which detects the genetic markers of viral particles in the bloodstream. A relatively expensive and complicated process and usually done on everyone with a positive HIV test (assuming they are being seen by a competent physician) to determine just how much replication is going on in the body.

In my own case, I presented with a viral load of 250,000+ copies per ml. Since beginning treatment that test has consistently shown what is called "undetectable" which doesn't mean I am free of HIV. It means that the number of copies in one ml are less than the detection threshold of the test. The gold standard for viral load testing is the ultra-sensitive assay which detects down to 50 copies per ml. Anything under that is "undetectable" and it the goal of antiviral therapy, meaning viral replication is being controlled.

If I were to go off HAART (antiviral therapy), I would likely remain undetectable for a few weeks and then my viral load would start climbing exponentially because antivirals are incapable of eradicating all reservoirs of the virus.

Some people have been documented to be HIV-positive (meaning they have antibodies) and are undetectable on viral load tests without treatment for some time. If this is what this story was, then there is no story as there isn't anything that hasn't been seen before.

That would mean that he seroconverted from positive to negative on the antibody tests. Which means no antibodies.