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PLEASE PLEASE 3 min. just give your opinion, PROMESE TO donate every 6 months.

Apr 23, 2009

Dear Dr. Bob. I dont know you but is a bless of God to have you for all of us...

First of all Congratulations for the excellent work you have done!! My experience is the next i had a broke condom in a insertive anal contact with a confirmed after vih+, i started PEP combivir and indinavir 36hrs after, and then switched combivir and kaletra due to toxicity, but i could finished the 28 day regimen; since then i have been tested negative until now 3 months after the exposure with antibody test, also i got a RNA PCR with <48 copies/ml 5 weeks after PEP, im been very very stressed, crying, trying to figure out what am i going to do, etc, PLEASE DR BOB this changed my perpective of life, i pray to God to continue negative. Id like your opinion to my question:

1. in your opinion, after how many weeks after PEP is a conclusive RNA PCR result ?. (CONSIDER YOU HAD TO GIVE AND ANSWER TO SOMEONE WHO CANNOT WAIT THE 6 MONTHS MARK).

I have read your answers about RNA PCR are not recommended for testing in the window period.

P.D. This is a promese to you and GOD, i will donate every 6 months for the rest of my life at least $300.

Sorry for my english im from Mexico.

Response from Dr. Frascino

Hi,

Your HIV-acquisition risk is unprotected (broken condom) insertive anal sex with a partner confirmed to be HIV infected. The CDC estimates the statistical per-act risk for this type of exposure is 6.5 per 10,000 exposures. Your statistical-risk estimate would be even lower, because you completed a full 28-day course of PEP (begun at 36 hours).

Your negative HIV-antibody test at three months is extremely encouraging. Yes, the CDC does recommend one final test at the six-month mark for a conclusive and definitive result.

HIV PCR RNA tests are not designed for HIV screening. Consequently I cannot give you an exact number of weeks for a "conclusive RNA PCR result." The one major reason PCR RNA tests are not used for HIV screening is their rate of false positives. False negatives, however, are usually not an issue with PCR technology. Therefore your undetectable RNA PCR at week five after PEP (over two months after your exposure) is extremely encouraging. The odds you did not contract HIV are astronomically in your favor. I would still get the final six-month antibody test, but you can certainly ratchet down your stress levels now! I'm very confident your final test will confirm my very strong suspicion that you are conclusively HIV negative. So put the celebratory champagne on ice, but don't pop the cork just yet, OK? However, I would certainly encourage you to begin practicing your "WOO-HOO," because I'm very certain you'll be using it soon.

Thank you for your generous donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). In return I'm sending you my good-luck/good-health karma that your final HIV test remains negative. I'm quite sure it will.

Good luck.

Dr. Bob



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