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HIV PEP TESTING and ARS

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  • HIV PEP TESTING and ARS

    I am a male, and i had unprotected vaginal sex with a stripper of unknown status( but she said she is clear). This happened on 3/17/2019 and i found online that PEP can be taken as post prevention as treatment. I started PEP with 24 hours and continued for 28 days.

    During PEP course, i got rashes, and severe fatigue. However, after completing PEP , i started having other symptoms like - extensive dry mouth, dry throat, dry cough, pins and needles, weakness, diarrhea , abdominal pain, mild fever, rashes on my trunk, shooting pains in arms and legs.

    At 5 weeks from exposure - I went to Infectious disease doctor, and she ordered HIV1 RNA Quantitate PCR, Syphilis, and throat culture and it was negative. and asked to complete a HIV 1/2 AG/AB test at 4 months from exposure (3 months after completion of PEP).

    At around 6 weeks from exposure, i went to my PCP, with symptoms- Enlarged submandibular glands, extensive dry mouth, dry throat, frequent throat clearing, pins and needles, weakness, diarrhea , abdominal pain, Muscle weakness, rashes on my trunk, shooting pains in arms and legs, chills , shiver. She did order- various VITAMIN D, Thyroid, Comprehensive Metabolic Blood test, CBC, Mono, HIV1 RNA Quantitate PCR. All tests were normal. Also i was diagnosed with anxiety and depression at the same time.

    At 8 weeks from exposure, still having the same symptoms, went to PCP , and following tests were done - Magnesium, SSA/SSB Antibody test (Sjogren Syndrome & lupus), Antinuclear Antibody (Rheumatic disease), Rheumatoid Factor, Comprehensive Metabolic Panel, Acute Hepatitis Panel, C Reactive Protien, Sedimentation rate - Erythrocyte, STI/STD( Gonorrhea , Chlamydia, Syphilis), All test results were normal.

    At 9 weeks from exposure, Still with the symptoms - PCP ordered ; HIV1 RNA Quantitate PCR. Hemoglobin A1C, HIV 1/2 AG/AB 4th Generation, NECK Ultrasound. As per reports, HIV results were not detected/ non reactive. Hemoglobin result was normal, And Neck Ultasound was No discrete Mass or Fluid in concerned areas, they are normal submandibular glands.

    Also around 10 weeks, i went to ENT specialist for Throat issue, he looked into through camera and told it is irritated and inflamed, and prescriped me Zantac for a month, as it could be GERD.

    At 12 weeks from exposure; still with less symptoms - PCP ordered STI test - Gonorrhea , Chlamydia, Syphilis, Hepatitis Panel and all were negative. also she prescribed - Anti Depressants - lexapro.

    Though, as per CDC 2016 revised guideline - even with PEP 12 weeks tests are conclusive, so i took (as my PCP did not order test, said we will do that at 4 months ) HIV 1 RNA Qualitative TMA(FDA approved for Screening), HIV 1/2 AG/AB 4Th generation test through online provided (Labcorp Labs) , and results were Negative and Non Reactive.

    During this period, i started developing mild fever of 99.1-99.5 in evenings, and sometime consistent through out the day and was getting many red spots on my back and shoulder and dry cough, throat,

    At 13 week, i again took, HIV 1 RNA Qualitative TMA(FDA approved for Screening), HIV 1/2 AG/AB 4Th generation test through online provided (Quest Labs) and they were Negative.

    At 15 week, i again took , HIV 1 RNA Qualitative TMA(FDA approved for Screening), and it was Negative & Not Detected.

    At 16 weeks, i went to Infectious doctor, explained her symptoms, - mild fever, chills, cold, throat issues, enlarged lymph nodes, red spots on back - she ordered - HIV1 RNA Qualitative PCR(Not Detected), ESB Virus (EBNA-1 1gG positive , EBV-VCA IgM negative - concluded as past, but not recent or current infection), CMV AB panel(CMV IgG Positive, CMV ism Negative, concluded as past, not current or recent infection), Tuberculosis( Negative) , Chest Xray (Normal). Also, she said if it was to be HIV even with PEP, the virus would should up, as PEP has been completed for 12 weeks, she said i clear of HIV.

    Also at 16 weeks went to ENT doctor as follow up, he checked my throat again, and said it is still same, and asks to do a month course of Proton Pump Inhibitor to treat GERD or acid reflux.

    At 17 weeks, (after waiting for so long got the appointment with GI doctor) - explained the whole situation and symptoms - he asked to do endoscopy and asked to take Proton pump Inhibitor for 2 months as my i has urge to clear throat all time, dry throat and bowel issues. Also he orders Hepatitis C Antibody test and Liver panel test, all were normal.

    At 18 weeks, went to PCP for follow up, and this time she order 4 months HIV antibody test - HIV 1/2 AG/AB 4Th generation blood test - this was negative as well.

    Also as per CDC guide line, it is mentioned that if you contract HCV along with HIV, in that case HIV can get delayed, therefore at 18.5 weeks i ordered HCV RNA Qualitative - TMA test and it is not detected.

    Now at 20 weeks, i still have symptoms; Enlarged submandibular glands in my neck, Frequent throat clearing, soar throat, low grade fever (99.1-99.6, between 4 PM to 9 PM), leg weakness, slight headache upon waking up. Sometime leg joint weakness.

    Should i go for further HIV testing or not?

    I am still very uncertain what is going on with my life. I already regret what i have done and feel shameful about it. My life has shattered completely upside down. Could you please suggest me something.

  • #2
    Thank you for your question and very detailed history. It is very clear from all the tests performed and the dates described, that you are negative for HIV and all other STDs tested. I do not think you need to undergo further HIV testing as clearly, you do not have HIV. Please move on from this.

    I would recommend that you visit your doctor for further review on whether your symptoms could be due to other underlying causes. It is also very possible that your symptoms could be psychosomatic i.e. caused by your anxiety and stress. If all other tests have come back negative, you should consider seeing a psychologist/psychiatrist for counselling.

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