Yes, there are a few people who are immune to HIV due to their genes

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Dr Flo,

Is it true that some people are immune to Aids or it’s just a creation of the media?
Mogaka

Dear Mogaka,
There are a few people who cannot contract HIV due to some genetic differences. The HIV virus needs to bind to specific proteins (receptor) on the surfaces of the cells it infects, for it to be able to gain access into those cells, like a key fitting into a lock. There are some people who are born with changes (mutation) to this receptor. For these people, even if they got the virus, the chance of contracting the disease is 100 times less likely than for someone with a normal receptor. This, mutation is most common in people of Northern Europe descent. The two people who were reported to have been cured of HIV were given bone marrow transplants for cancer treatment from donors with this mutation, so the new bone marrow made blood cells that had a defective receptor and the HIV they had now had no cells to live in.


Can a HIV/Aids patient adhering to medication spread the virus when their viral load is low?
Simeon

Dear Simeon,
When a HIV positive person takes the correct medication consistently, the level of the virus in the body and in the blood goes down. The amount of virus in the blood can be measured using a test called a viral load test, which is done regularly to see how someone is doing on medication. With good adherence, the target of treatment is to achieve an undetectable viral load. This means that the number of viruses has gone down to the extent that the viral load machines cannot detect any viruses in one milliliter of blood. It is important to note that undetectable viral load in blood doesn’t mean that the HIV is cured. The virus particles may be few in the body, but if you stop taking antiretroviral medication, those few viruses multiply very fast and attack your body.


When your viral load is so low that it is undetectable, the risk of transmitting HIV sexually is negligible, but there is still a small risk of transmission through labour and delivery, and also through breastfeeding, and there may still be a risk of transmission through shared needles. However, if there is no proper adherence to medication, the risk goes back up.


Dr Flo,

Why is there no known cure for viruses? If there’s one vaccine found for coronavirus, would this be a big relief for HIV positive patients? Robert

Dear Robert,
A vaccine for coronavirus would not assist in the fight against HIV. Every vaccine is specific to the specific virus. There are ongoing HIV vaccine trials.
The reason why viruses are difficult to treat is because on their own, viruses are not exactly living organisms. They are tiny, inert particles that come to life once they come into contact with a host cell in a living organism. They then hijack the cell mechanisms to make more viruses. Antibiotics work by attacking the disease causing agents themselves e.g. by attacking the bacterial cell wall or interfering with their replication. But because viruses are not exactly alive, you cannot target them. You can only target their interactions with the living cells e.g. by blocking their entry into a cell. The immune system is usually quite effective in dealing with a majority of viruses, but sometimes the virus particles are too many (high viral load) or the nature of the virus makes it difficult to fight. To make it worse, some viruses can lie dormant in an area of your body for years then cause problems later when the body’s immunity is low e.g. Herpes.

Dr Flo,
For how long does a HIV positive patient have to be on medication?
Mary

Dear Mary,
A HIV positive person has to be on treatment for life. This is because once the body is infected with HIV, the virus remains in the body for life. Taking medication reduces the number of viruses in the body, but does not completely get rid of it, there are always some viruses hiding somewhere in the body. Once the number of viruses goes down, the body has an opportunity to recover and go back to near normal condition, allowing a HIV positive person to live a normal life. The immune system is able to recover and the risk of opportunistic infections, cancers and other conditions also goes down significantly. Taking medication, in addition to improving someone’s health, also reduces the risk of transmitting the virus to others.

Dr Flo,
Why do so many people fear being tested?
Julius


Dear Julius,
Many people believe what they don’t know cannot hurt them, so they would rather not know their status. In addition, the HIV diagnosis is life long, and testing positive means you are positive for the rest of your life, which will mean changes in how you live e.g. taking medication for life and changes in sexual relationships. There is still stigma associated with a HIV diagnosis, and it may cause changes in perception of self and it may also affect how some people interact with you in personal and professional relationships. Since most HIV infections are sexually transmitted, testing also has implications on past or ongoing relationships. There is also a challenge for those who are at risk of or acquire HIV from their parents.

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