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worry worry worry.

Aug 7, 2009

had sex with a hiv positive woman,nov 4 2007,tested negative with ELISA,twenty days after,a doctor gave me zidovudin as PEP from the twenty fifth day which i could take only 20 tablets for 10 days and stoped because of side effects.tested again -ve at 2 months.-ve at 3 months,at 4 months,at 5 months, and also at -ve at 6 month and 2 weeks. over 5 months now, i have a lump in my left breast which is tender and mildly painful sometimes.the swollen part feels normal without swlling some times in the day. please help, cant sleep, cant eat.

worry worry worry.

i want to clarify some issues about the qustion i just asked.i did not use condom,had it only once for abot 8 minutes, the mark on the test kit that showed her test as positive was faint, the doctor said her load was weak

Response from Dr. Frascino


I need to highlight several important issues in your post:

1. Unprotected sex did place you at some degree of risk for STDs, including HIV. Consequently HIV testing is warranted.

2. The appropriate HIV diagnostic screening test is an ELISA (EIA, rapid test or equivalent) taken at the three-month mark. HIV-antibody tests taken prior to the three-month mark are not considered to be definitive. Because you had a significant exposure with a partner documented to be HIV infected, the CDC recommends a follow-up test at six months as well. Your negative HIV test at "6 months and 2 weeks" is definitive and conclusive. HIV is not your problem. No way. No how.

3. PEP (post-exposure prophylaxis) was not warranted in your situation. To be effective PEP needs to be given as soon as possible and no later than 72 hours after an HIV exposure.

4. Even if PEP was warranted (which it was not) using zidovudine as monotherapy is not recommended. PEP should be a combination of two or three antiretroviral drugs.

5. You took PEP for only 10 days. A complete course of PEP is 28 days.

6. Whatever is causing your current symptoms, one thing is certain: It's not HIV! I suggest you have your general medical doctor evaluate your problem.

7. That your partner had a "faint" reaction on her HIV test does not mean that her HIV viral load is weak! The doctor who told you this was again mistaken. HIV-screening tests measure anti-HIV antibodies and have nothing to do with HIV plasma viral loads.

8. I'm concerned by the medical care and advice you've been receiving. From the information in your post it appears the physician did not understand HIV testing (confusing viral load and HIV-antibody levels), inappropriately prescribing PEP (way beyond the 72-hour limit) and using inadequate mediation (zidovudine monotherapy) for PEP. I'd suggest you consider find a more competent physician.

Dr. Bob

Do I need to start HAART?
Condom failure

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