I had a very high risk incident, unprotected anal sex, with me the passive partner, with someone who 2 days later found out he was positive, I went on PEP at 60 hours. During my routine STD check halfway through PEP Gonorrhea was found and treated.
2 weeks after stopping PEP I developed a weird illness - light headedness, dizziness, "unreal" sensations, this passed after a few days and I tested negative using a fast test.
3 weeks after stopping PEP I developed very swollen lymph nodes in my neck, pain in groin - I got examined and they confirmed the swollen lymph nodes in neck, none found anywhere else, and did a 4th generation lab test which came out negative, they got me in 7 days later to repeat the test and again, it was negative (this was 4 and a half weeks after stopping PEP, 8 and a half weeks after the incident).
I've also had rashes on and off on neck and chest, no fever thankfully- and my neck lymph nodes are still enlarged
I went in for my 6 week post PEP test, syhphilis and HIV negative (10 weeks after incident, 6 weeks after PEP)
1. I notice you have confidence in 4th gen duo tests 28 days after an incident, would you be as confident with PEP involved, and with the level of risk that I had. My 42 day post pep negative, how confident would you be that this will stay the same at 12weeks
2. If my enlarged lymph nodes was due to HIV, would you have expected one of the tests to show positive?
3. I haven't had a fever - is this a good sign?
4. I went to my GP to have them examined, and he asked me halfway through if I'd had unsafe sex which obviously has set my anxiety levels off again - If PEP slowed down the virus so that it was in my body but not replicating, would this be the cause of my swollen lymph nodes but no P24 or antibodies showing? Surely it's not normal for someone to have swollen lymph nodes in neck for this long
5. You say you've never, in your clinic, seen someone become positive after testing negative after PEP from the same incident, are these people with as high a risk as I had ?
Forum and also been subject to a huge amount of spam which has been unhelpful.
I've copied and pasted your question beneath to do it proper justice:-
[quote]
Quote:
I had a very high risk incident, unprotected anal sex, with me the passive partner, with someone who 2 days later found out he was positive, I went on PEP at 60 hours. During my routine STD check halfway through PEP Gonorrhea was found and treated.
2 weeks after stopping PEP I developed a weird illness - light headedness, dizziness, "unreal" sensations, this passed after a few days and I tested negative using a fast test.
3 weeks after stopping PEP I developed very swollen lymph nodes in my neck, pain in groin - I got examined and they confirmed the swollen lymph nodes in neck, none found anywhere else, and did a 4th generation lab test which came out negative, they got me in 7 days later to repeat the test and again, it was negative (this was 4 and a half weeks after stopping PEP, 8 and a half weeks after the incident).
I've also had rashes on and off on neck and chest, no fever thankfully- and my neck lymph nodes are still enlarged
I went in for my 6 week post PEP test, syhphilis and HIV negative (10 weeks after incident, 6 weeks after PEP)
1. I notice you have confidence in 4th gen duo tests 28 days after an incident, would you be as confident with PEP involved, and with the level of risk that I had. My 42 day post pep negative, how confident would you be that this will stay the same at 12weeks
Although the other chap discovered he was HIV positive a few days after you had had sex we don't know from the data you supplied whether he was a very freshly infected HIV positive man or simply discovered a pre-existing infection. It is important as with very new infections the "infectivity" of the other person is greatly magnified. If I became HIV positive today then for the next few months at least I will be very infectious - thereafter my infectiousness will decline. You raise an important question with respect to the use of the DUO and post PEP. HIV DUO tests are very accurate indeed at 28 days after an event. PEP may complicate matters -I say may because we don't truly know the answer. What I can say is that in our collection of patients who test in similar circumstances to you but at 1 to 2 weeks after finishing PEP and who test negative on a DUO , none have gone on to become HIV positive.
2. If my enlarged lymph nodes was due to HIV, would you have expected one of the tests to show positive?Yes - I think that is entirely to be expected.
3. I haven't had a fever - is this a good sign? Yes, I would say it is.
4. I went to my GP to have them examined, and he asked me halfway through if I'd had unsafe sex which obviously has set my anxiety levels off again - If PEP slowed down the virus so that it was in my body but not replicating, would this be the cause of my swollen lymph nodes but no P24 or antibodies showing? Surely it's not normal for someone to have swollen lymph nodes in neck for this longWell look, irrespective of whether its normal to have lymph nodes for this length of time, your GP was doing exactly what he or she should have done and made the right enquiry. Your comments about relpicating virus etc are understandable but are not actually valid.
5. You say you've never, in your clinic, seen someone become positive after testing negative after PEP from the same incident, are these people with as high a risk as I had ? No - I haven't said that - what I have said is that where people have tested negative a few weeks post PEP using an HIV DUO test then they have not gone on to become HIV positive on later testing with the same incident - not the same as the quote you've attributed to us/me.
On balance, looking at your questions I think tHAT despite the high risk nature of your encounter, the fact that you have tested negative to date is very encouraging.
Sorry for misquoting you, it was not my intention, and thank you for answering my questions.
He believes he was newly infected, (he had a flu like illness over christmas) but his first set of labs showed a VL of 2800, which is low I think - but obviously the risk is so high still , and with the gonorrhea that increases it.
Anyway, thanks for your response, I know that I will only get a definate answer to what has happened 3 months post PEP - and I would actually be quite confident with my 6 weeks duo negative that I got on Monday, but the fact that I have these swollen lymph nodes (and other random stuff, like pins and needles in feet etc, slight rash on neck a week ago) does make me think that I've not been so lucky.
No worries re the misquote - I just wanted you to understand what I had said and sometimes I'm not clear!
Christmas is a relatively recent time although a viral load of 2800 at this point 3.5 months in would lead me to think the infective episode for him was sooner.
However, in some ways that doesn't really make any difference at all as the available evidence suggests that the lower the viral load the lower the possibility of transfer - and certainly I would put a transfer possibility at VL 2800 as very low indeed.
Yes, the gonorrhoea will statistically increase the chances of acquisition - but a bit like crossing the road where I believe (don't quote me) theres a risk of something like 1 in 300 of being run into /over - it doesn't happen for most of us. I for example have not been run over yet.
Again, whilst I take on board your anxiety I think ultimately that we will have a good outcome.
6 week negative post PEP
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