Can Hiv-PEP trigger CFS-like illness?

[zottolo]

Hello,

I would be very happy to understand if my current health issues may be related to a recent Hiv PEP:

- I had a risky contact at the end of July, 2012 (condom broke, me insertive, partner likely to be Hiv+: he didn't insist on condom use)
- I started PEP 3 hours later (Truvada/Kaletra) and continued for 28 days, but I was not informed that I had to take Truvada with some food.
- 9 days later I developed an ARS-like disease (maculopapular rash on chest and arms diagnosed by physician, high fever, night sweats, sore throat) which made me think that PEP had failed. But Hiv specialists told me that it was not possible to develop ARS while on PEP. It was a very severe illness, which lasted for about 5 days. I had never experienced anything like this before.
- All the tests came back negative for Hiv and other STIs. (Hiv ab at 2 weeks, 1 month, 3 months, 4 months and 8 months post risky behaviour, Hiv-1 PCR at 5 months). In addition, they did a C4 and C8 count, which apparently is in the normal range (C4 627, C8 396).

Apparently I do not have hiv. However, about one month after the last dose of PEP my health started deteriorating. I developed massive fatigue, my face is puffy and I have dark circles around the eyes, I suffer from recurrent diarrhea, frequent low-grade fever, gain in weight etc. Fatigue is worst, since I cannot work properly anymore. This is going on for half a year now.

Doctors don't really know what is happening to me and think I might have developed a chronic fatigue syndrome; some think it's a post-traumatic fatigue, some speak of postinfectious fatigue (but without being able to tell me what infection I had...). Blood tests revealed a high cholesterol level, low vitamine D and B9 levels and some markers of pancreatic insufficiency, everything else was +/- normal.

Do you think that PEP can trigger symptoms like these? Should I get tested for Hiv again? Any other ideas?

Thank you very much for your help!

[Dr Sean Cummings]

Hello again,

This further information confirms that everything is in fact ok and you do not have HIV or hepatitis.

I would follow your doctor's and Jose's recommendations.

best wishes, Sean

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you for your post and welcome to our forum.
There is no doubt that you do not have HIV at all whatsoever.  You negative test results are final and fully conclusive.
Your symptoms do certainly correlate with chronic fatigue, for which we cannot often find a cause.  It is true that the stress of the whole situation, together with having taken PEP might have triggered this.  Restoring those low vitamin levels might help.  If all the other tests were normal, it will just be a matter of time for you to start feeling better.  I would advise you to follow your doctor's recommendations.
Best wishes,
Dr José

[zottolo]

PS: Perhaps it is also useful to know that I did antibody tests for Hav, Hbv and Hcv at 2 weeks, 3.5 months and 5 months post exposure as well as a PCR test for Hcv at 5 months, all of which came back negative.