The pair have spent the past few weeks flirting with each other but now one of them must leave the house on Friday.
The overwhelming bookies' favourite is Paul who is 1-20 odds on to leave.
Helen and Paul both received three nominations each, with all the other housemates voting for them.
But Brian, Dean and Elizabeth all seemed to have agonised over their decisions.
Elizabeth said of her decision to nominate Paul: "He's the person I least connect with.
Viewers' attention
"He's a nice guy but it goes down to who you get on with more."
Elizabeth herself was nominated by both Helen and Paul, receiving two votes each.
The focus of viewers' attention will now be on Helen and Paul's relationship.
The 24-year-old car designer has already expressed his concern at meeting Helen's boyfriend "Big G" in the studio if he is the one to leave.
But unbeknown to Helen, "Big G" has already ended the relationship because he is so embarrassed by her behaviour in front of the cameras.
Helen, 23, has now been nominated three times while this is the fifth time for Paul.
Last week saw Josh leave the house in Bow, east London, following in the footsteps of Amma, Bubble, Narinder, Stuart and Penny.
After the seventh person leaves on Friday, viewers will then have the chance to vote for the overall winner of the series from the four housemates remaining including Dean, Brian and Elizabeth.
Winner
The contestant with the fewest votes will be asked to leave the house next Thursday, 26 July and the public will then choose their final winner from the last three on Friday, 27 July, the final day of the series.
Brian is still favourite to win the £70,000 at the end of the series with odds of 20-1 against being kicked out.
All remaining housemates were showing signs of being unsure of their positions, psychologists said on Monday.
Footage taken in the both the girls' and boys' bedrooms showed most of the contestants talking more and more in their sleep.
Paul was talking particularly loudly. He has also shared his dreams with the rest of the house.
He told them about his "James Bond" dream in which he was irresistible to women.
He then carried on to talk about the most terrifying dream he had, in which he "was spinning around and chopping people's heads off".
Attraction
Since the contestants' arrival in the house, the attraction between Helen and Paul has grown visibly stronger.
On several occasions they have sloped off to the den together, spending hours alone.
Helen was heard telling him Paul her relationship outside the house was not "serious".
But he is still wary of taking their relationship any further.
Evicted housemate Josh has said Paul is just playing the game and has no intention of carrying on with the Helen after the show ends.
Two more have now been removed because of the illness, but the housemates have been reassured their own health is not in danger.
Last year Marjorie the chicken became a celebrity in her own right.