If I'm not mistaken Dr. HHH is an STD epidemiologist, which deals with the incidence, distribution (transmition) and control (including prevention) of STD in the (or a) population.
People that come here want to know if they are or were at risk of exposure of HIV. The above mentioned discipline deals with this (amongst others STD) sort of issue. Dr. HHH has an unquestionable reputation in this field. Feel safe here if what you seek is knowledge on risks of transmition.
Dr. HHH is only been responsible when he declines to abund in questions of form, structure and treatment of HIV once it is acquired.
If a person wants to know what happens to him/her AFTER he/she acquires HIV, then they need to seek care, advice and treatment with an hematologist or an immunologist.
Take care and good luck
I really thought you were an expert in the field of HIV. I know you went to Africa for research on HIV. I know your not taking the place of our own Dr. when it comes to advice on HIV, but why answer such questions if you really are not an expert. You sure kind of hit me where it hurts on this new information. How reliable has your info. really been. Thanks Alot!
I have read normally within the first 4 weeks ARS occurs.
Regarding PEP and testing, it would seem logical to me that if the virus is kept at a low enough level, then your body would not have a reason to mount a full immune response like it would if the virus was allowed to replicate normally. But I don't know, I am not a doctor.
I did find the following:
1) "Circumstances for which extending the duration of follow-up have been suggested include the use of highly potent antiretroviral regimens (i.e., more than two drugs) because of theoretical concerns that HIV seroconversion could be delayed, or simultaneous exposure to HCV"
http://www.medadvocates.org/diagnostics/cdc/hcw_guidelines.html
2) Timeline of infection, you can see when the viral load is highest is around the time ARS occurs, and seroconversion is commonly suggested around this time as well.
http://en.wikipedia.org/wiki/Image:Hiv-timecourse.png
3) Dr. Bob seems to think PEP would not affect antibody testing, only PCR, hopefully he is right.
http://www.thebody.com/Forums/AIDS/SafeSex/Archive/TransmissionSexual/Q165017.html
I hope this will help you some, without misleading.
Thanks for the reply. Last question - typically, how soon after infection (let's just assume non-pep for now) would symptoms appear?
Doctor H is an expert on Std's and the epidemiology of HIV if I am correct....
The docs on thebody are immunologists/hiv specialists etc.
Dr. Bob provides a more detailed opinion on PEP here:
http://www.thebody.com/Forums/AIDS/SafeSex/Archive/Treatment/Q165487.html
My expertise is primarily in the traditional STDs, not HIV/AIDS except in regard to transmission, prevention, and interactions between HIV and other STDs. So except for question 1, I really cannot answer you very well.
1) It is logical that transmission risk is lower without ejaculation than with it. But to my knowledge there are no data either on this point or on the amount of HIV in pre-ejaculate fluid compared with semen. Therefore, I cannnot venture a guess about how much lower the risk might be (and I doubt anyone else can either).
2) Seroconversion and ARS occur on more or less the same time frame. My guess is that delayed seroconversion--which is extremely rare anyway--is even more rare in people with symptomatic ARS. But this is well outside my expertise.
3,4) Sorry, I do not know whether the symptoms are delayed or otherwise changed in ARS occur despite PEP. As far as I know, there is no reason not to exercise while on Trizivir.
Sorry I can't be more helpful. Thebody.com is an excellent online resource about HIV/AIDS. Even better, have you posed these questions to the provider who prescribed PEP? S/he probably knows more than I do.
Good luck-- HHH, MD