Jul 30, 2001
Dear Doctor Little, With your knowledge of acute infection and HIV medications I would like to ask you for information about my situation. I came down with a fever, swollen glands and night sweats 72 hours after insertive vaginal sex with a high risk woman. Based on that, I began PEP(combivir-sustiva) for 30 days. I tested negative for hiv1/2 at 13 weeks post exposure. I plan tofollow up at 6 months and one year. Would you recomend PCR-DNA testing as well because of PEP? Can PEP arrest or delay antibody production? Will I ever know for certain if I am negative, or will having taken PEP cloud the issue. My initial symptoms presented within 3 days and lasted one week. Does that sound like acute HIV? If I were fortunate enough to be under your care how would you advise me to proceed? Thank you for your valuable time. Sincerely, John
Response from Dr. Little
In general, symptoms of acute HIV infection do not begin within 3 days of exposure - the more common presentation is within about 14 days. Regarding your testing, I do not recommend HIV RNA PCR testing in this setting. It sounds like you have already had the appropriate testing and PEP and have the correct plans for follow-up testing. I would not alter your current plans.
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