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HIV PEP, ARS and Testing

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. I haven’t met my doctor after test results, but i still have symptoms - Enlarged submandibular glands in my neck, Frequent throat clearing, dry throat, tightness of throat, which keeps nothing me and doesn’t allow me to do anything in my life.

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.

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.
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366749 tn?1544695265
Your do not have HIV, it is not the infection but the guilt and regret that happens to be a killer for us.  Any 4th generation test done four weeks after the exposure or the same duration after finishing the PEP is conclusive.

Your tests are accurate and conclusive. RNA Qualitative PCR and Duo test results supplement each other and confirm that HIV is not your issue definitely.

First you have to come out from the mindset and fear you carry after the episode. You do not have HIV that you have to assure yourself. Probability of HIV transmission from a single isolated act of unprotected sex with someone of unknown health status is not very significant, and you have so many odds in your favor. You have already completed your PEP and post completion results are final and conclusive.

For your complaints, seek medical attention with a clear thought in mind that HIV is NOT your problem

Helpful - 0
I have read so many places, that PEP can delay Seroconversion. I am really worried as my symptoms are bot resolving- i feel fatigue, week legs, uncomfortable throat, soar throat, acne or red bumps on back, chills, flu like symptoms.

Also many journals say, if pep is adminsterd then HiV window is 6 months, and RNA test are not reliable with PEP.

Do i need to take test at 6 months/ 24 weeks. I am in my 20th week. Please advice- also should i use HIV Proviral DNA test, if RNA is not conclusive with PEP.
I don't know where you are getting your information, but it is 1) wrong, and 2) horribly outdated.  Your tests are conclusive.  If you are having medical issues, they have NOTHING to do with HIV.  Speak to your doc about your non-HIV related symptoms.  You don't have HIV.
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