Apr 10, 2019
It’s okay to stop antibiotics once you feel better. After all, superinfection means that it’s better for you!
seen from Kuwait
seen from Pakistan
seen from Japan
seen from Malta
seen from Netherlands
seen from United Kingdom
seen from China
seen from China
seen from Malta
seen from Belarus
seen from Germany
seen from Germany
seen from Türkiye
seen from United States
seen from Netherlands
seen from South Africa
seen from Israel
seen from Brazil
seen from United States
seen from Indonesia
It’s okay to stop antibiotics once you feel better. After all, superinfection means that it’s better for you!
Hello - I'm HIV + and on medication with and undetectable VL. How common is reinfection between two individuals who are both positive and have unprotected sex? I say this because I do date people of the same status but when it comes to sex I really don't know if they truely are undetectable or not unless I ask for some proof which seems silly in the dating game. Thus, I'm asking you in your forum for your opinion. Thanks
Reinfection is quite uncommon, especially in people with long-standing infection. It may occur more easily in people who were recently infected (e.g. less than 1 or 2 years).
Dear Doctor. I have read Its not seen yet a person developing resistance to Dolutegravir. So based on this, how likely do you think is for a person taking a Dolutegravir based regimen to get superinfected? thank you in advance
It’s not true that no one has ever developed resistance to dolutegravir. To date there have been no reports of dolutegravir resistance in people taking it as initial therapy (without prior resistance).
Superinfection is uncommon and not something you should spend time worrying about. But if you were taking a dolutegravir-based regimen, you presumably could not be superinfected by any virus unless it was dolutegravir-resistant.
Hi Dr. Joel, I think I already know the answer to this question but hoping you could put my partner's mind at ease. I am on Genovya, they are on Strilbid. We are both undetectable. I would take it the risk of superinfection is non existent since the medications are basically carbon copies of each other with Genvoya just having less toxicity. We would have the same strain since we were originally on the same medication. My partner thanks you in advance for your answer.
If you both have undetectable viral loads, superinfection is not a concern regardless of the medications you’re taking.
Part 3 continued... is it safe for me to have unprotected sex with my partner? I have been with positive partners before (top, bottom) however they were always on medications and undectable viral loads. Is it dangerous for either one of us to contract a super infection if their viral load does not quite qualify as undetectable? Thank you for the guidance. I understand elite controllers if that is what my partner is are extremely rare.
There are two issues here: the risk to you, and the risk toyour partner.
There is very little risk to you.First, superinfection is quite uncommon. Second, you’re on treatment that wouldprevent superinfection except from a drug resistant virus (has he been testedfor resistance?). Third, his very low viral load makes it unlikely that hewould transmit HIV to you even if you could be superinfected.
The risk to your partner is also low. He may not be an elite controller, but he’s close. (Elite controllershave consistently undetectable viral loads without treatment.) We don’t know whether such people benefitfrom being on therapy, but there is some evidence that they might. Your partner probably has higher levels ofchronic inflammation and immune activation than you do. That has generally been the case when elitecontrollers are compared with people whose viral loads are suppressed onART. Theoretically, the higherinflammation and immune activation could cause long-term problems, such as ahigher risk for heart disease, malignancies, or cognitive problems.
If I were your partner, I’d startmedications, but I’ll admit that that’s based on educated opinion rather than solidclinical data.
My husband and I have been having unprotected sex and we both are HIV positive. We both were diagnosed at the same time and we're on the same mess. A friend of mine said that we should stop having unprotected sex because we may become super infectious and I'll be hard to a drug that will keep our viral load down. We're both undetectable too. What are your thoughts about the situation? How much is the truth?
Your friend means well, but his worries are exaggerated. First, both of you have undetectable viral loads. As long as they remain that way, neither of you is going to transmit HIV to the other. Second, you may be infected with the same virus. Third, HIV superinfection is a pretty uncommon event.
1) If I am positive with undetectable VL + high CD4, the chances of PASSING the virus (doing receptive anal and oral, the guy won't have contact with my seminal fluids) is "close to zero", as I've read. Is that correct? 2) My doc says it's actually a risk 'cause it would be bad TO ME to risk having more virus into my bloodstream. I'm on tenofovir+lamivudine+efavirenz. Can that be considered like a PrEP against recontamination? Would take something else (ex: emtricitabine) be good in that sense?
I’ve answered your first question dozens of times in the last few months, so I invite you to scroll down.
Your doctor is presumably referring to the risk of superinfection (reinfection with a different strain of HIV). Superinfection is uncommon, and your medications would protect you against infection with a drug-sensitive strain. Theoretically you could still be superinfected with a strain that was resistance to the drugs you’re taking, but I can’t say I’ve ever seen that happen.
Emtricitabine is almost the same drug as lamivudine. You would never take both drugs at the same time.
Hi Dr., curious about the whole coinfection, superinfection issue. What would happen, or I guess what could happen if someone who is HIV positive, on ART, and undetectable has unprotected sex and gets infected again?
Superinfection is uncommon, but it can occur. The risk is greatest if you’ve only been infected for a short time. Being on ART probably reduces the risk of superinfection, just as PrEP prevents primary infection. However, if you were to have sex with someone whose virus was resistant to the drugs you’re taking, it’s possible that your ART regimen would no longer work. This hasn’t been well documented, but it’s a possibility that people worry about.