Question
How long should HIV ARS last when PEP medication fails?
6 July 2022. Related: All topics, HIV testing, PEP/PEPSE.
Hi,
How long should HIV ARS last when PEP medication fails?
I had a high-risk exposure with an HIV+ CSW when the condom broke. I developed a bruise after the condom broke, due to poor lubrication, which increased my risk.
I started PEP at six hours post exposure (TLD). I received 30 tablets and took them all religiously. However, after 16 days, I developed headache, diarrhea, night sweats, swollen lymph nodes in the groin, abdomen and neck, as well as body aches. The diarrhea stopped on day 18. On day 21, I developed a dry cough which was accompanied by an irritating sensation going deep down in the chest. On day 24, the irritating sensation whenever I coughed expanded to include the throat.
On day 31, after completing the PEP dose, I went to a hospital for an HIV text, which came back negative.
However, on day 33, the headache, swollen lymph nodes, and body aches intensified significantly and I also developed some minor chest pain. On day 35, I noticed a white spot at the back of my throat. Today is day 36; the cough has subsided but still lingers a little. However, the headache, lymph nodes and body aches remain significant.
I am certain that the PEP failed and that I am undergoing HIV ARS. My question though is, how long should the ARS last? I have read that HIV ARS lasts one to two weeks but this has now lasted three weeks.
This bothers me because I feel as though I contracted a really bad variant of the virus, for which the body is taking longer than usual to complete the seroconversion. I intend to go ahead and start my ARV treatment but the hospital will not give me ARV treatment before the tests turn positive, which can only happen after the ARS ends. Is it common for people to experience HIV ARS for longer than three weeks?
Answer
Hi, how are you doing?
As you have mentioned, ARS can last from a few days up to a few weeks. For most, 2 weeks is the earliest that ARS will resolve. It is not uncommon for ARS to last longer than this.
Your doctors are right not to start you on ART yet. As you do not know if you are positive, ART can suppress how tests work in the earliest stage of seroconversion. This is for the same reason that testing while on PEP is not accurate.
Starting treatment now may mean you are starting treatment that is not suitable for you. Waiting these few weeks will not have a harmful effect on your health.
Why have you considered your exposure with this CSW as high risk? As you started PEP so soon it is much more likely that it was effective. There are many infections/illnesses that can cause the same symptoms you are experiencing – a big one in this case is stress.
Another factor could have been a poor reaction to PEP and you are experiencing side effects. Have you been able to discuss with your doctor any other causes for your symptoms?
Josh.
Hi Garth, do you know the name of the medication you took as PEP? and what is the flu medication you have been given?
I have been exposed 7 weeks ago and I used pep or prep but symptoms like fever,running nose and swollen glands appear two weeks after I used the medz. Should I consult a GP as I did but gave me flu medz and it does not seem to work.
Hi Mohammed, do you know the name of the PEP you are taking? and have you noticed any other symptoms? e.g., fever, sneezing, runny nose?
I started pep 11 days back, have had symptoms like diarrhoea, head but now I have this severe neck pain, kindly tell me whether it’s an effect cause. It’s really too much
Hi Maria, did you look at your result in the time frame that was instructed? At home tests are only accurate for a specific amount of time. If you did and this was a faint line it would be appropriate to go to a health clinic. You will be able to have a second confirmatory test to be sure of your status.
I have finished pep 6days ago. I tested 3 days after pep and I had positive results with a faint line. Are the results true?
Hi Sibo, HIV tests will not be accurate until 6 weeks after PEP – you will need to use a 4th generation test. Before this tests are not accurate and can give a fake result. As you finished your course of PEP, this is not likely HIV. It is also a little soon for these symptoms to be caused by HIV. The symptoms you are experiencing are very common with most infections e.g., flu, COVID and a cold. Your symptoms are more likely to be caused by these than by HIV.
I finish my pep medication but one week after i head a dry cough flue n heard pains n i went to the clinic i test negative so am worried cos the flue is n headache is worries me so my question is the really pep helps or it no i have to wait to start for Arv
Hi,
Thanks for responding.
The reason i am worried is that the symptoms seem to be more severe than for most cases I have read online. Although I have had no fever or rash, I have had literally everything else. And now, I realize I have experienced weight loss; and have lost just under two kilograms in the past month. My worry is that the weight loss will continue if I do not get medz soon. How severe is weight loss during seroconversion? Last week i consider self-treatment by buying the medz across the counter but I have been warned this could be dangerous.
I consider my exposure high risk because even if I am circumcised, I developed a bruise during the exposure which creates an easy passage way for the virus. Also, I think the CSW was not on ART treatment.
I do not think it is PEP side effects. In fact, the PEP was so well tolerated that I feared I had been given fake medication.
For sure I am stressed, but the combination of all these symptoms, which got worse right after I stopped PEP, must mean that it is seroconversion and that the PEP was only limiting their impact, which after it stopped, they escalated.
Thank you for the support you are providing.
M.M.
Hi Myles, I recognise why you are anxious but in most cases there is no transmission of HIV. Many of the symptoms you have mentioned can be caused by the stress of waiting for a test. Have you been able to speak with anyone?
The Terrance Higgins Trust can offer more support than i-base in your current situation: https://www.tht.org.uk/contact-us