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HIV transmission between partners

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My partner and I are both HIV+. we believe that he has contracted hiv from me because the doctor believed (without being 100%sure) that he had newly become HIV+ during the time of the test. However we had only had safe sex (4-5 times, with protection but also without ejaculation) before we both got tested HIV+. is there a way to find out for how long we have been hiv+ and also if he contracted hiv from me or vice versa? of note is that even if we both got checked for the genotype of HIV and were found that we were not resistant in any medicine and also my partner has been taking successfully truvada and kaletra, when i started the same regiment (6 months after my partner) , i developed resistance to kaletra and all protease inhibitors within 4 months after I started the medicines. (i never missed any doses or had sex of any kind during this period or the period after i was diagnosed hiv+). My viral load never became undetectable during the period i was taking kaletra. thank you

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replied February 7th, 2010
HIV and AIDS Answer A9833
Hi, welcome to the ehealth forum and I am glad to help you.
Your concern is regarding who transmitted the HIV virus to other-you or your partner and who has a recent infection with HIV and who has an old infection. You also seem concerned about resistance to kaletra and all protease inhibitors(PIs).

A negative HIV antibody test and a very high viral load (>50,000 copies/ml) indicate recent HIV infection, most likely within the past two months. If both tests are positive, then HIV infection probably occurred a few months or longer before the tests. A special "detuned" version of the HIV antibody test is less sensitive. It detects only those infections that occurred at least four to six months before testing. It can be used to help identify cases of acute HIV infection. It is presently used as a research tool only.
Kaletra (Lopinavir/ritonavir) is a fixed dose combination of lopinavir and ritonavir and is used in combination with other antiretroviral agents. It belongs to the class of antiretroviral drugs called as protease inhibitors. Usually, resistance to kaletra is seen in patients who have been treated with other PIs previously but new mutations can always develop in patients using PIs for the first time as well. Also, resistance emerges more rapidly in late stage patients presumably the result of greater viral replication and a greater opportunity for mutation. The compliance of patient to ART is also important as missing doses or not adhering to guidelines regarding adequate dosages of drugs can promote resistance to PIs. Genotyping that you have undergone to determine antiretroviral drug susceptibility is not without its limitations as it identifies mutation in the predominant viral quasispecies only; not able to detect minority viral species (< 25% of viral population, depending on the assay)and relevance of many mutations remain unclear and can be difficult to interpret in the presence of numerous mutations. Cross resistance is a serious problem in ART. Sometimes, when HIV becomes resistant to a drug you are taking, it will also be resistant to other ARVs - even if you haven't used them yet. This is called "cross-resistance". Many ARVs are at least partly cross-resistant. If your virus develops resistance to an ARV, you might not be able to use any other drugs of the same type and so has happened in your case with resistance to all the protease inhibitors once resistance to kaletra developed.
I sincerely hope that helps. Take care.
Note: This post is not to emphasise final diagnosis as the same cannot be made online and is aimed just to provide medical information and no treatment suggested above be taken without face to face consultation with health care professional.

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