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significance of negative duo test straight after pep?
Hello...
I contacted you last week regarding an exposure in South Africa just over a month ago to a girl of unknown status. You said then that the risk was very very low. I now have another question. To summarise my situation, I had just had my wisdom teeth removed following infection, while she had had a tooth removed the day before. There was 'deep' kissing, mutual masturbation, and I had put my finger in my mouth for one moment. Due to very high risk demographic and the area, I was put on truvada for a month, due to open wounds in the mouth, having not successfully found out her status. Her age group is about 25% HIV infected, I should have thought about that before. I'm still friends with her though she is scared to get tested.
I wouldn't have asked you again were in not for the worsening symptoms I'm going through. I very rarely get ill but now have increasingly swollen lymph nodes in the groin area, still have badly sore throat for 2 weeks, have lost noticable weight and as of today very achy muscles and joints. No rash but a had fever two weeks ago which lasted a couple of days. I had taken truvada for one month up until the most recent test 4 days ago. The test came back negative today at 28 days, plus test was negative at 21 days, both duo tests.
My question is about the negative result from this recent duo HIV test (28 days) and whether it has any more significance since the test at 21 days test, bearing in mind I had taken Truvada for a month.
It feels like I have had all the symptoms of HIV the last couple of weeks but I'm not sure if the test would have shown up positive due the fact I had taken pep? Or put a differently, if these symptoms were due to hiv, would it mean that the pep had failed and the test could have shown postive, even during the course of pep? My other question is whether this could be my body's reaction to truvada? Worryingly none of the symptoms have changed since finishing the pep.
Many many thanks again...
I contacted you last week regarding an exposure in South Africa just over a month ago to a girl of unknown status. You said then that the risk was very very low. I now have another question. To summarise my situation, I had just had my wisdom teeth removed following infection, while she had had a tooth removed the day before. There was 'deep' kissing, mutual masturbation, and I had put my finger in my mouth for one moment. Due to very high risk demographic and the area, I was put on truvada for a month, due to open wounds in the mouth, having not successfully found out her status. Her age group is about 25% HIV infected, I should have thought about that before. I'm still friends with her though she is scared to get tested.
I wouldn't have asked you again were in not for the worsening symptoms I'm going through. I very rarely get ill but now have increasingly swollen lymph nodes in the groin area, still have badly sore throat for 2 weeks, have lost noticable weight and as of today very achy muscles and joints. No rash but a had fever two weeks ago which lasted a couple of days. I had taken truvada for one month up until the most recent test 4 days ago. The test came back negative today at 28 days, plus test was negative at 21 days, both duo tests.
My question is about the negative result from this recent duo HIV test (28 days) and whether it has any more significance since the test at 21 days test, bearing in mind I had taken Truvada for a month.
It feels like I have had all the symptoms of HIV the last couple of weeks but I'm not sure if the test would have shown up positive due the fact I had taken pep? Or put a differently, if these symptoms were due to hiv, would it mean that the pep had failed and the test could have shown postive, even during the course of pep? My other question is whether this could be my body's reaction to truvada? Worryingly none of the symptoms have changed since finishing the pep.
Many many thanks again...
Thank you Dr so much for the reply...
These symptoms are freaking me out still but its good to know that they are unlikely to be HIV related..
These symptoms are freaking me out still but its good to know that they are unlikely to be HIV related..
MEDICAL PROFESSIONAL
As best we know, it is impossible to have symptoms due to HIV with negative tests for both HIV antibody and for the virus, either by PCR or by p24 antigen. In other words, to the best of my knowledge, your negative Duo test proves you are not infected with HIV, even in the face of PEP. Combining these factors with the low risk nature of your exposure -- despite a South African partner in a "high-prevalence demographic", as I think you put it in your other thread -- it is exceedingly unlikely you have HIV. Your symptoms almost certainly have another explanation.
That said, I have little personal experience in actually prescribing PEP or providing care to patients who have received it, or in assessing adverse effects from Truvada. It would be wise for you to find a provider with experience in doing so, and anybody taking PEP should be doing so under direct professional care. If I correctly recall from your other thread, you are now back in the UK. Your nearest NHS GUM clinic would be an excellent source of such care. If you prefer the private sector and cost isn't an important limitation, you could visit Freedom Health (if you're in London), the clinic operated by the moderators of MedHelp's international STD and HIV forums.
Perhaps Dr. Hook will also have a response to this same follow-up question in the other thread. But I don't expect it to be much different than this reply.
Regards-- HHH, MD
That said, I have little personal experience in actually prescribing PEP or providing care to patients who have received it, or in assessing adverse effects from Truvada. It would be wise for you to find a provider with experience in doing so, and anybody taking PEP should be doing so under direct professional care. If I correctly recall from your other thread, you are now back in the UK. Your nearest NHS GUM clinic would be an excellent source of such care. If you prefer the private sector and cost isn't an important limitation, you could visit Freedom Health (if you're in London), the clinic operated by the moderators of MedHelp's international STD and HIV forums.
Perhaps Dr. Hook will also have a response to this same follow-up question in the other thread. But I don't expect it to be much different than this reply.
Regards-- HHH, MD
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