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Newly Infected need guide ASAP please. (Donation just sent, Hernan)
Jun 8, 2010

Newly Infected need guide ASAP please. (Donation just sent, Hernan) Hi Dr Bob, ( I am sorry for my basic English ). At this time, The Body is my best resource of support. But I still need some answers for my specific situation. Here are the facts first: On April 26 I started heterosexual relations w/ multiple sex workers in Thailand like there was not tomorrow. On May 6, I went to the local hospital with heavy HIV acute infection symptoms. They did test hiv antibodies and stds,( all negative) and put me in PEP: kaletra, Viread and Lamivir for 28 days, and to answer my questions the Dr. said: If this is acute hiv infection PEP wont stop it and you may have rash next week. Back in California, on may 14, I meet a infectious disease specialist Dr. with the extensive lab results requested by her, all neg. including viral load. (found little anemia). She took my case seriously and told me that viral load may be undetectable because of the meds. Her plan, before any further treatment is test for antibodies two weeks after finish the PEP , five weeks after , and so on and go from there. Today, three weeks on PEP and symptoms of HIV acute infection I still with night sweats, rash, fatigue and now with white spots under my tongue. Sadly, I have no doubt that I am acute HIV infected, and probably with the Thai subtype, E (CRF01 _AE ), and please ASSUMING for a minute, that this is the case , Dr. Bob, here are my Questions. 1) I am 43 y/o hispanic with acute infection, fast track HIV subtype, with no other health problems, I would start HAART ASAP even if for lifetime , regardless my initial viral load/ CD4 ratio. That is my feeling. Does it make sense? 2) If starting lifelong treatment, is there any possible prognosis or quality of live benefits if start before seroconversion rather than weeks after? 3) If yes, according to my timeline ( a month from first exposure and 3 weeks with symptoms and PEP), should I still wait to the antibodies test shows positive or I should also ask to test viral load also to achieve acute HIV diagnosis before seroconversion? 4) And, assuming, that may be a subtype E (CRF01 _AE ), can I relay in the standard viral load tests to detect this subtype or should I ask for a specific type of test? 5)I feel that my PEP is denying the option to treat acute infection since there is no detectable viral load, however I still adding HIV acute infection symptoms. Is there any pro or cons being on PEP during acute infection? 6) Since I am on PEP will I still be qualified as newly infected for possible trials purpouses? 7) Any other advise on my case? I m sorry for brake the rules.Thank you Dr.Bob, Best Regards. Hernan. ( May 29, Los Angeles , CA )

Response from Dr. Frascino

Hi,

The HIV-acquisition risk associated with the activities you describe are:

1. Essentially nonexistent.

2. Essentially nonexistent.

3. Essentially nonexistent.

The primary reason to consider HIV testing would be psychological; for peace of mind. Your results would undoubtedly be negative.

Thank you for your support of The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. I would suggest you spend some time reviewing the wealth of information in the archives of this forum. I've addressed concerns exactly like yours many times before. I'm confident you'll find the information reassuring. While reviewing the archives, pay particular attention to exactly how HIV is and is not transmitted.

Be well.

Dr. Bob



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