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what to do?
Jul 14, 2008

Iwant to start by saying, hello and thank you for helping out in this world. If everyone was like you, there would be less worries in this world.

My risks were very high. unprotected receptive anal 4 months ago. Yesterday, some guy took off the condom and came inside of me. I had no idea until I came home and went to the bathroom.

I am very concerned for my health.

my first ? is,

If my liver enzymes are coming back normal and I have tested negative for hcv and hiv at 4 months after my last possible exposure, does this mean that I am not infected from that particular exposure?

I have pain in my right abdomen for about 1.5 months now. Also have pain where my spleen is on the left.

I'm concerned because I was violated yesterday and now am on PEP which I think is going to throw everything out of whack for me. I heard that it can do liver damage and I would have to test now for 6 more months to a year.

I have had many symptoms that lead to abdominal pain. Symptoms such as joint pain, clay, green colored stools. Undigested feces and the runs. eye pains and floaters, severe lower abdominal pain, Never had these problems. Only started 2 weeks after my last encounter 4 months ago. It started as a shock to my system. I'm still feeling pains in my knees and shoulders, liver and spleen. And no one is helping me because I'm not getting a diagnosis which concerns me even further.

I wanted to know that if I contracted a coinfection 4 months ago, how long will it take to test positive for both diseases if I continue pep? Should I get off the pep if I have pains and concerns? Or do liver enzymes prove that my liver is healthy regardless of pain?

If I'm negative for both, when can I be sure 100% that I am not infected? It's so difficult when you have all of these symptoms to believe in test results. And all the contradictions about testing acuracy. What is one to do in my shoes?

I can't date anyone, I don't know if I'm healthy or not. I just started living my life.

I'm in school studying to become a shrink and I have more problems than any one that I personally know.

Response from Dr. McGovern

Thank you for your very nice comments. It is very gratifying to know that the website is helpful.

Many points I would like to make:

1. Testing for your first exposure seems to look good so far. Four months out and you are still negative - this is very reassuring. 2. Yes I would definitely take post exposure prophylaxis (PEP) for this second exposure which is of concern. Yes HIV treatment can cause some abnormal liver function tests but that is more of a concern in someone with underlying liver disease who is taking chronic therapy. 3. As for your other symptoms, you should have a full physical examination and should be checked for other STDs. 4. I would continue testing for HIV and HCV out for six months. I would only test for HIV at 12 months if - and only if - you also develop new hepatitis C infection. 5. You should do some preventive things like obtaining Hepatitis A and B immunizations.



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