Quick question.. you mentioned paying quite a bit of money for Combivir. Does the NIH not cover all prescription drug costs? I was under the impression that it did. Not to say that the money you paid wasn't well spent!
Hello,
First of all, let me try to help you to put things into perspective and bring some logic to the whole equation. Both incidents, though involving some degree of risk of HIV infection, had a relatively low risk for this. This is because we assume firstly that the ladies were positive (which is a lot of assuming as statistically most people are negative, even among sex workers, excluding Sub-Saharan Africa); secondly you used a condom for at least part of the intercourse (which reduces the risk of transmission); thirdly, the estimated risk for the man involved in insertive vaginal intercourse without a condom from a single episode is less than 0.01% (less than 1 in 1,000) and lastly, you took Combivir as post-exposure prophylaxis, which is really only required for four weeks following exposure (even though it should be started within 72 hours of the exposure, which you did not do, and possibly this was not really necessary in the end anyway) Bearing all this in mind, I do not think that you have become infected with HIV. The initial symptoms happened far too early (less than 2 weeks) for them to be related with acute seroconversion and the numbness in the nose has absolutely nothing to do with it. I am sure some of the symptoms you have had experienced were side effects from the anti-retrovirals. It is said that taking PEP affects the reliability of the HIV test. However, in my experience, when PEP fails, the virus is able to replicate, your body produces antibodies, and you can detect the infection very soon after finishing the course of PEP. But if we stick to the clinical guidelines, one needs to wait 12 weeks from the end of the course of PEP, which would be week 26 ( I assume that you finished taking Combivir at week 14). Therefore those negative HIV tests at week 34 would be totally conclusive. I think all the stress you are under is causing most of the symptoms. I am convinced you are HIV negative. Try to forget about it and move on!
Best wishes,
Dr Jose