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Symptoms 2 days after finishing PEP.
Mar 31, 2009

Hello Doctor, I am a full time pre-med student/ part time worker. I love what you are doing with this website, very helpful!

I had insertive anal sex with a sex worker of unkwon status about a month ago. The whole act lasted for no more than 10 secs before I realized I was doing something wrong and pulled out; there was no visible blood present.

I went to to the ER within the 72 hours and I was started on the Kaletra/Truvada regimen for 28 days; I got through the regimen with only minor side effects and finished 6 days ago.

Now, here are my questions:

1. Do you consider my exposure to be high risk?

2. 2 days after stopping PEP I developed a runny/very stuffy nose with post nasal drip, a mild sore throat, some greenish discharge through the nose and what I describe as bad sinus headache(with some pressure on the face and forehead); I had a fever of 101 on the second night after developing these symptoms which quickly went away after taking 2 Advils. Then I had a second fever of 99.5 on the third night; then no more fever after that. I noticed a very small little ball with no pain (lymph node) just below my left ear which I have not felt there before and the lymph node below the back part of my right mandibular felt tender and with some mild pain when touched.

Are thsese symptoms ARS related? because I stopped the PEP and I am converting? or are these symptoms related to something else like sinusitis? (also, I have sinus problems and have a habit of using Afrin for the past 5 years). If it was a sinus infection or another type of infection besides ARS, could it also produce my lymph nodes to be tender?

3. The doctor has ordered a HIV P24 antigen test and a HIV viral load test. Are these the right tests to follow up after finishing PEP? If not, what would be the right tests and when should they be done?

Thanks for your time Doctor.

D.

Response from Dr. Frascino

Hi Pre-med Stud,

1. No.

2. No. No. Yes. Yes.

3. The guidelines suggest HIV-antibody testing at baseline, 6 weeks, 12 weeks and 6 months from the date of exposure.

Good luck! I'm very confident you'll test definitively negative.

Dr. Bob



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