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Early treatment
Sep 20, 2001

Please let me know your opinion with regard to the following. A person strongly believes they have been infected with HIV, ie. they have had unprotected sex with an HIV person, and 2-4 weeks later they develop diarrhoea, severe muscle and joint pains (particulary on tops of feet, elbows, knees and finally fingers), mild fever, swollen neck, and night sweats which may be indicitive of HIV seroconversion. It is 1 month since they have possibly been infected - would it be best at this stage to wait a further 2 months and take an ELISA test - which will confirm/deny HIV infection for definite; or, would you recommend the person to begin taking HIV anti-viral drugs which, if the person is indeed HIV+, could help him/her in the long run?

Response from Dr. Feinberg

In this situation I would get tested right away--after even one month, there is a good likelihood that you'd have a positive test IF you really are HIV-infected. In many countries there are study centers looking for people with newly-acquired HIV, so it may be quite easy for you to find the kind of research-oriented testing that can determine whether you have HIV or not even before the standard test would be positive. (You spelled diarrhea in the British style, so contact the Medical Research Council if you are in Great Britain and see what they have to offer. But wherever you are, there is likely to be an HIV research network that may be helpful.)

In my opinion, it's probably wise to start antiviral drugs as soon as possible. There is evidence that people who begin treatment early have better-preserved immune function. That's the driving force to find out whether you do or don't have HIV after all. Good luck!


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