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Anal sex with HIV positive person whose Viral load about having HIV? 4400. Chances of me
Mar 16, 2011

I'm sorry i'm not good in English.(This topic was posted from Thailand)

I want to ask you some questions about chances of getting HIV.

Last week i had anal sex with my partner. we protected with condom but it ended up breaking and he ejaculated inside me.

next morning we checked for HIV antibody and it appears that he is positive. so i decided to start post exposure prophylaxis drugs which are combined tab (Lamivudine and Zidovudine) and efavirenz. the first pill was taken 13 hours after i had sex.

Is it true that it will reduce risk up to 90% (from 1/200 to 1/2000)?

and today my partner had checked his CD4 and Viral load. It comes out that he has CD4=452 and Viral load=4462.

i know that chances of getting infected are composed of many factors including partner's viral load.

so i want to ask you wether this viral load is high or not. and the chances of getting HIV is changed from 1/2000 or not?

i have worry about this for 2 weeks and cannot wait until 6 months for check my blood.

and one more question. From your experiences, how many people who take PEP but still get infected?(especially in recipient anal sex)

Hope you reply soon Thank you

Response from Dr. Frascino

Hello,

Receptive anal sex with a partner confirmed to be HIV infected is very risky business, particularly because your top gun was apparently not on antiretroviral therapy. PEP begun 13 hours after the exposure will help abort or prevent viral transmission/acquisition. I can't confirm the 90% figure, because there are many variables involved with HIV transmission. These involve both the virus (viral strain, viral load, etc.) and the host (immune integrity, concurrent infections, local trauma, etc.). A viral load of 4,462 is not considered very high, but any detectable viral load is worrisome.

As for PEP failures, they can and do occur. (Yours truly is an example!) With the newer, more potent antiretrovirals, it is hoped there will be fewer treatment failures.

Regarding post-PEP HIV testing, the guidelines recommend HIV-antibody testing at four to six weeks, three months and six months.

Good luck.

Dr. Bob



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