Hi during July 2013 I had flu like symptoms which lasted about 2weeks. I was tested for HIV at the beginning of August and the result was positive viral load 90000 but a cd4 count of 760. I started treatment on 15 august taking truvada and stocrin. I have two questions 1)Assuming the drugs work how long does it usually take to reduce the viral load significantly ? My next blood test is mid October. 2) what is the risk of passing on HIV at this stage of my infection if my partner (hiv negative) gives me oral sex and gets small amounts of my precum in his mouth and I don't ejaculate and I am not not even close to ejaculating.
2015-02-12 05:49:49
I'm sorry to hear of your HIV infection. But I'm also very glad to see you are under care and on treatment with top-of-the-line antiretroviral drugs. It is also good news that your initial viral load was modest (many people start out in the millions) and you started treatment before your CD4 count declined significantly. The prognosis is excellent for very effective control of your infection. Assuming your doctor is an infectious diseases specialist or otherwise highly experienced in HIV/AIDS management his or her knowledge probably is as good or better than mine. Of course you should ask him or her the same questions if you haven't yet done so. But here are my comments: 1) The initial response typically is quite rapid and you can expect your October test to show a substantially lower viral load -- perhaps even undetectable. 2) Transmission of HIV by oral sex is rare. Even without treatment the average risk has been calculated in a publication a few years ago by the US Centers for Disease Control and Prevention (CDC) at 1 transmission for every 10000 events -- equivalent to daily exposures for 27 years before transmission might be likely. That said the CDC data did not take into account whether the infected partner had acquired HIV recently viral load or ARV treatment. There also are no data on whether or not ejaculation in the mouth makes any difference. Since it is likely your viral load has already declined significantly my guess is that in the cirumstances you describe your partner would be at very low risk but I cannot venture a guess at the numerical probability. As you may know even with the highest risk sexual practices -- unprotected anal sex -- the risk of transmission is near zero in people on ARV therapy who have undetectable viral loads. Undoubtedly the already low risk of transmission by oral sex would also be zero or close to it. Anyway my advice is that you and your partner use condoms even for oral sex (and certainly for anal) until you know for sure your viral load has responded well to treatment. It's probably only a month or so -- I'm sure you can stand the wait! I hope these comments are helpful. Best wishes for successful treatment--
2015-02-12 05:50:22
