Expert: Gorkey Gourab - 2/11/2009

Question
QUESTION: There are some men who impregnated their HIV+ wife without infected even without the use of condom. How does this Happened? Also if the CD4 count of the HIV+ woman is low or high does this has any implication on the man if he has a sexual inter course.
And lastly, what are scientists doing about this deadly disease . When will a cure be found?
Thanks.


ANSWER: Thank you so much for the questions. Here goes the answers :)

Q: There are some men who impregnated their HIV+ wife without infected even without the use of condom. How does this Happened?
A: When one among the couple is HIV positive and the other is not, they are usually known as HIV-serodiscordant couples. There are few instances which show that it is possible to impregnate a woman without infecting her and their child if the man with HIV is taking antiretroviral drugs like highly active antiretroviral therapy (HAART) (Romero et al, 2007). Romero in their study showed that serodiscordant couples attaining natural pregnancy are exposed to a negligible risk of sexual transmission of HIV when the infected partner presents with complete suppression of plasma viremia while receiving HAART. However, in their study, one case of transmission did occurred. Thus, to me, it’s not a surefire way.

Q: If the CD4 count of the HIV+ woman is low or high does this has any implication on the man if he has a sexual inter course?
A: A normal CD4 count in a man without HIV infection will be approximately 400 to 1200 cells per cubic millimeter of blood, and 500 to 1600 in women. Initially in HIV infection there is a sharp drop in the CD4 count and then the count levels off to around 500-600 cells. When someone is infected with HIV for a long time, the number of CD4 cells they have (their CD4 cell count) goes down. The count shows the extent of damage done by HIV in an infected person … the lower the count, the higher the damage done. Thus, to my limited knowledge, it is an indicator which has no implication of sexual intercourse.

Q: What are scientists doing about this deadly disease? When will a cure be found?
A: Finding a permanent cure for AIDS is difficult as a cure for AIDS must somehow remove every single one of the infected cells. Some of the world’s top research institutions are today engaged in studies to learn more about the behavior of HIV, resting CD4 cells and other hiding places (AVART, 2009) and thereby finding a way to cure AIDS permanently.

However, in November 2008, a group of German doctors made headlines by announcing they had cured a man of HIV infection by giving him a bone marrow transplant (McGroarty, 2008; Wallace, 2008). The transplant - given as a treatment for leukemia - used cells from a donor with a rare genetic mutation known as Delta 32 that confers resistance to HIV infection. Twenty months after the procedure researchers reported they could find no trace of HIV in the recipient's bone marrow, blood and other organ tissues.

The ultimate status so far for permanent AIDS treatment is research in this area is in its very early stages; it may be many years before a useful treatment is found, if at all (AVART, 2009).

:(

Regards,
Gorkey


---------- FOLLOW-UP ----------

QUESTION: What of if a man is HIV positive but the wife is HIV negative and they want a baby without artificial insemination. Is it possible to have a sex without the man contacted the HIV? Is the risk as high as when a woman is not HIV but a man has HIV?

Answer
Hello Alex,

Hope you are fine.

The technical term used to refer to such couples is 'serodiscordant'. Well, frankly speaking, while few among such couple proved to have uninfected status, despite unsafe sexual intercourse, the chance is very high to get transmitted by the positive one among the couple. Therefore, the answer is ... yes, the risk of transmission is very high.

Regards,
Gorkey