2nd time writing. Post PEP. Please Help - Deperate
Jun 10, 2007
Dear Dr Bob, Thanks for all your humanitarian efforts. I had unprotected insertive vaginal sex with a promiscuous female and was then treated by my PMD with Combivir/Tenofovir for 4 weeks for this exposure. I had 2 6wk tests on May 26th(2wks after completion of PEP): Elisa (negative) and RNA-PCR (not-detected). I however am still very freaked out and keep finding new symptoms on myself everyday : neck/groin lymph nodes, chills, bone and joint pain, weakness, night sweats but no fevers or rash. I don't know if the 6wks test meant anything and if I should be reassured at all ? What is the best timeline for further testing to definitively rule out the disease? Please write back with some good Karma and and information about my likelyhood of having acquired HIV form this horrible mistake. Please.... I promise to make a donation to your worthy cause that I can afford. Thank you so much.
Response from Dr. Frascino
If possible, I recommend anyone who has had an exposure significant enough to warrant a course of PEP be followed by an HIV specialist. The reasons for this include:
1. The HIV specialist can accurately document and assess the true HIV risk.
2. He can optimize a PEP regimen, as well as monitor and manage any PEP-related side effects or toxicities.
3. He can order and interpret all follow-up tests per established guidelines.
For instance, in your case I would not recommend RNA PCR for routine HIV screening, due to the rate of false-positives, other technical considerations and cost. Also, if this test is run while someone is on antiretroviral therapy, the results would reflect the effect of treatment rather than HIV status.
Your negative six-week test results are extremely encouraging. Your "symptoms" are not worrisome for HIV ARS or HIV disease and most likely are the result of anxiety. The post-PEP testing guidelines recommend HIV antibody testing at the three-month and six-month marks. Take a read through the archives. You should find the PEP-related testimonials both enlightening and encouraging. Thanks for your tax-deductible donation to The Robert James Frascino AIDS Foundation. In return I'm sending you my best good-luck/good-health karma that your definitive post-PEP follow-up HIV tests remain negative. I very strongly believe they will.
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