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After PEP Questions
Sep 30, 2012

Hello sir,

I had a recent high risk exposure. My condom broke while i had vaginal sex with a csw of unknown status and unprotected oral sex after. This is the first time this happened and i am HIV- to begin with. I took PEP about 5 to 6 hrs later (Combivir and Kaletra) and continued it for 28 days. I took my first dosage at 05.00 to 05.30hrs and 2200 to 2230hrs everyday without fail. I had sinus and cough and develop joint and muscle pains as well as a white hairy tongue somewhere along the course of the medication with the usual associated symptoms associated with taking the drugs such as fatigue and diarrhoea. I got tested at the 4th and 5th(and 5 days) week post exposure and the results were negative (via rapid test), the 5th week being 1 week and 5 days after PEP meds. Currently i still have a cough though not so bad but my joints still hurt quite badly. Also after brushing my tongue it looks better. I'm currently in my 7th plus week post exposure. Questions are,

1) Some ppl told me that PEP doesnt delay sero, others told me otherwise. I'm afraid with the things that i'm feeling that i might be seroconverting. i have no rashes. No fever, just like a moment of feeling heaty for awhile before it goes off. Doesnt last more then a day.right now its just cough and joint pains and a slight whitish tongue.

2) Are my negative test results reliable? Am quite distressed. Should i take another test at week 8 post exposure? That will be 4 weeks off PEP. How conclusive will that be?

Thanks for the time sir. Am really hoping for the best. I've learnt alot from here and am looking forward to your advice.

Response from Mr. Cordova

Hi there:

1) Seroconversion would not be delayed by the course of PEP. If you were to experience ARS, they would most likely also include a fever. Also, while your broken condom was a risk, a one-time incident of penetrative vaginal sex, where you were the insertive partner, and there was some condom use does not sound like a terribly high risk incident to me.

2) By 28 days, most people will show up reactive, or positive on an antibody test. However, you must wait until the 90 day mark for a conclusive result. While your 8 week test is not conclusive, I would feel confident in the negative result. I suggest that you get a final test at the 90 day mark just to be sure.

In health,

Richard



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