A case of human immunodeficiency virus (HIV) infection without increase in HIV RNA level: A rare observation during the modern antiretroviral therapy era.

It is known that some with human immunodeficiency virus (HIV)-positive patients can remain immunocompetent for long period, maintaining their CD4-positive T lymphocytes (CD4 cells) while suppressing HIV. However, this population became rarely seen recently since potent antiretroviral therapy (ART) became available worldwide, and the latest guidelines recommend initiating ART regardless of the status of immunity of the patients. Herein, we present a rather unusual case of HIV-1 infection, where the patient was hospitalized for 3 years and was accidentally found to have the infection, without increasing his HIV RNA level in serum although his CD4 cells were decreased.