Hi,

I had anal sex with a man of unknown HIV status (me insertive). Very unfortunately, the condom broke. I started a PEP treatment (Truvada/Kaletra) about 3 hours later and took it for 28 days. Initially, I took the pills on an empty stomach, because I was not informed that I had to take Truvada with some food in order to increase bioavailability.

I was quite confident that the treatment would prevent me from getting infected, but after nine days I developed fever, sore throat, and a scary rash on my chest, arms and armpits (maculopapular, according to my physician). Symptoms lasted for about 5 days. Approx. 2 moths after treatment I developed again a more discrete rash on my arms, lasting again for a few days.

I had negative antibody tests at 2 weeks, 1 month, 3 months, 4 months, 8 months post exposure, as well as an undetectable HIV-1 RNA PCR at 5 months. A HCV PCR was also negative at 5 months. A CD4/CD8 count was also done. CD4: 627, CD8: 396. I found that low, but they assured me that it was in the normal range.

About 3 months pot exposure, I developed a massive fatigue, which is is still present. I had to reduce my workload by 50%, I sleep 10 hours a day and still wake up exhausted. Myalgia, puffy eyes, pale skin etc. are just some of the symptoms I am experiencing.

I am trying to find out what I am currently going through and I have developed several hypotheses. Perhaps you could tell what you think?

a) exposure to HIV and subsequent PEP treatment triggered a chronic fatigue syndrome. Would this be a possible long-term effect of PEP? Might PEP have caused a dysfunction of my immune system?

b) I got infected with another (not yet identified) virus and developed a post infectious fatigue.

c) I was infected with HIV but my body has not developed antibodies yet. The treatment protocol I received says that one should get tested at 6 months post PEP and should not donate blood for 12 months after incident. This makes me think that seroconversion can take up to 12 months. 

d) The fact that initially I took Truvada on an empty stomach may have led to infection. But I started to take the pills with some food about one week after exposure. I have read reports that people who start HAART during ARS may produce antibodies very late. Does this also occur with PEP?

My physician cannot figure out what is causing my problems. He says that HIV is unlikely, given the numerous tests. I try to believe him, but this debilitating fatigue is really depressing and makes me think that something is going on inside my body.

Thank you very much for your kind help, which is very very appreciated! You are providing a great service!

Hugs,

zot

Hello All,
I hope you are well!

Congratulations and Thank You for all the work you do and support you provide for troublesome minds!

I am just after some of your experienced and professional knowledge and experience.

I had a possible exposure to HIV through unprotected oral and vaginal sex (1/12/12) and started PEP the same day (14 hours after the event). I have kept myself busy for the duration of the past 4 months. I have been attending my local GUM clinic I believe as required.

Baseline test (05/12/12): Negative
Completion of PEP: 28/12/12
4 weeks after completion of PEP (28/1/2013): Negative
8 weeks after completion of PEP (27/2/2013): Negative
12.5 weeks (90 days) after the completion of PEP (28/3/2013): Negative
I believe that all tests were carried out with 4th Gen HIV DUO tests.

So, my questions are:

- I have seen guidelines explaining that a conclusive test can be taken at 6 months, is this just a precautionary measure? I believe the UK BASHH guidelines say a 4th Gen HIV Duo at 12 weeks completion of PEP is conclusive?

- I have suffered from Ulcerative Coltitis for many years and have had a stoma for the past 6 years, and I had major bowel surgery on 9/1/2013. Would this have any effect on my results?

The reason that I am still a little anxious, is that I have a partner and we are looking to start our own family in the near future. I just want to ensure that i am 100% certain and not to put anyone else at risk.

I fully appreciate the work you guys carry out. Thank you again for all of your help and support.

Best Regards,
Paul

Hi, I'm currently in Thailand and a little worried... I'm a 32m and uncircumcised. I stupidly inserted my penis into a transsexual for around 30 secs to 1 min, there was blood involved which i quickly washed off, there were no cuts on my penis, but maybe small friction burn in my foreskin, also some seaman got into my eye and throat, but very little. 12 hours later i was prescribed and took Lopinavir/Rit (100/25mg) and Truvada, which i have to continue for 28days...4 lopinavir/rit tablets with 1 truvada in evening, and 4 lopinavir/rit in morning, this correct? I've been taken this for 2 days and feel extremely fatigued, is this normal? when will it subside? how effective is this medication? % wise? also what is the risk of having contracted HIV? can u give me a %? i was negative on receiving the meds, I'm really really really scared, i forgot to mention, the transsexual turned out to be HIV POSITIVE!!!!! Please help I'm going out of my mind!!!!!