PEP Treatment

[scpatient]

Dear Doctor,

On 11-Apr-2013 I had a sexual relation with my new wife as follow:
- Two times Vaginal Sex (with condom)
- One time Oral sex in her Vaginal (note: I had some cuts in my Gum and some broken teeth)

After two days I discovered that she is infected with HIV positive.

On 15-Apr-2013
One doctor prescribed PEP (Combivir + Kaletra) and I start it at the same day which is around 100 hours after the relation.

Now I am suffering from the side effect of the PEP for (9 days). And someone told me that the pep is not effective after 100 hours. And this will delay the HIV test.

Should I continue with the PEP, or stop it.

And if I stop it now is there any consequences.

Many thanks for your support

[H. Hunter Handsfield, M.D.]

PEP always prolongs the testing period, often extending the period of a patient's anxiety about HIV.  That's one of the reasons to be cautious about PEP.  But at this point, stopping won't make any difference -- you're going to have a more prolonged test period already.

That's the end of this thread, except if you want to post your doctor's recommendation about continuing PEP.  I will delete any other kind of follow-up comment.

[scpatient]

Thanks Dr. Hunter for your feedback

My Doctor in my country have a very precaution conversation with me..

That why I am seeking your advise regarding the prons and cons of completing\stoping PEP treatment after 9 days and would effect the HIV test period.

Thanks againg and sorry for prolongation.

[H. Hunter Handsfield, M.D.]

I doubt the "cuts" in your mouth (canker sores? tooth injuries?) or broken teeth made any difference in your risk.  But this is also something you can discuss with your doctor.

[scpatient]

Dear Dr. Hunter,

Many thanks for your reply..

however I need you adive as a seconde opinion. if there is any consequences if I stop it now after my doctor approval.

and regarding the oral sex, I had some cuts in my gum and some broken teeth and this is what I realy worried about. is it risky !

Thanks..

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  However, I'm afraid I cannot help very much.

Once someone is in direct care for a health problem, the place to go with questions or concerns about it is right back to the doctor or clinic providing that care.  I would not presume to tell you either to continue or stop PEP in this circumstance.

I will say that I'm not sure PEP was necessary in the first place.  Vaginal sex with a condom is safe sex, and oral sex is extremely low (maybe zero) risk.  However, if your wife has a high viral load, perhaps PEP was a good idea.  These are things you should discuss with the doctor or clinic, as well as your side effects.

Whatever you do, I recommend you not stop PEP without first talking to the doctor.  The worst thing would be to take PEP intermittently -- i.e. to stop and then start again.  This can increase the chance of infection with a drug-resistant strain of HIV.

I'll be interested to hear what decision you and your doctor make about it.

Best regards--  HHH, MD