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Truvada/Isentress PEP Working? Advice and other Q's?
Jan 2, 2014

Hi, I was recently prescribed Truvada and Isentress after unprotected sex (receptive without ejaculation followed by insertive with ejaculation) with another male that told me after-the-fact that he is HIV+. I went to the ER after about 10 hours and was innitially given Kaletra. I was then prescribed Truvada and Isentress. I took the Truvada immediately (at about 10 hours), and the Isentress later that night. I have taken Truvada once in the morning and Isentress twice a day at 12-hour intervals (plus or minus an hour or so here and there). First, I'm concerned that I'm either doing something wrong (i.e. having taken a pill with food, having a glass of champagne on New Years, over-metabolizing the drugs too quickly... I don't know). I have had zero side-effects. I suppose I should be happy with that, but it seems that I'm the only one without any, and strangely enough - it makes me worry that the drugs aren't doing what they're supposed to. Second, I had an opportunity to go to the ER immediately after exposure, but spent the day researching before going and lost about 10 hours of time. Have I impacted the efficacy by waiting those 10-11 hours and would the change from the ER-given Kaletra to the prescribed ISentress matter? Lastly, I have been also been dating a guy that is known negative (and I was tested immediately prior to the prescription). What are the odds that I am currently contagious to him while on PEP and given the level of risk of my exposure? I apologize for the number of questions, but these have been swirling around in my brain for the last few days. I appreciate your time and your help!

Response from Dr. Young

Hello and thanks for posting your questions about PEP.

1) No side effects is entirely a good thing and not a reason to be concerned. Alcohol itself (in moderation) isn't a problem with HIV medications and the ones you've been prescribed (and most HIV meds) can be taken with food.

2) There's no evidence that waiting the extra few hours to start PEP would make a difference (unless you go past 72 hours); nor any reason to worry about the switch in regimens. Indeed, the later regimen (with Isentress) is now my preferred PEP/nPEP regimen.

3) While it's a very good thing that you're on PEP and the risk of acquiring HIV is very low,one must think that your possible exposure was of sufficient concern to warrant being on PEP, then the possibility of having HIV must be of at least theoretical concern. I would try to factor this into any possible future sexual exposures- or at least until you have that negative 3 month HIV test.

Hope that helps, BY

Effectiveness of Truvada/Isentress vs Stribild for PEP
HSV co-infection

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