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 Timothy, PEP is not required to be taken with or without food. As you started PEP so soon and continued the course for 30 days at the same time you did everything correct. There is no reason to think PEP will not have worked.
Have you been to see a doctor about your symptoms? As you adhered well to PEP it means it is very unlikely that your symptoms are caused by HIV. These symptoms are very general and is much more likely to be caused by something like the flu/covid.
After 4 weeks you can test using a 4th generation test. This will be 95% accurate and can help alleviate some stress. You can then take the same type of test 2 weeks later which will confirm your result.
Dealing with anxiety around testing: https://i-base.info/guides/testing/hiv-testing-feelings-of-fear-anxiety-and-guilt
Please help, i had uprotected sex with an Hiv+ person, we tested the same day and found that she was Positive, after 6 hours of exposure i took PEP at 7pm everyday for 30 days, but i was not given directions on how to take it, like before or after a meal, so i sometimes took it before meals and sometimes after a meal ( is this not a foctor to pep not working?).
a weak or 2 after PEP, I sterded feeling an itchy or minor sure throat and a mild dry cough, then i felt mild body aches… im worried that Pep has not worked and its been 3 weeks now since i finished PEP. IM WORRIED AND IM STRESSED, last night i had night sweats. (i was given TRENVIR tablets)
Hi Keenen, this test is conclusive. You do not have HIV and you do not need any further tests.
For further information please see here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Hi I’m so scared. I took pep( acriptega)on the 22nd of June until the 23rd of July. And on the 7th of September I did 4th generation HIV test which came back negative. That’s 11 weeks after exposure and 7 weeks after pep but now my throat is blocked, I have diarrhoea, groin pain and I still have a rash. Im convicted pep didn’t work and That I have HIV but it can’t be picked up on the tests.
Hi Francis
Thanks. Please see this factsheet on PEP that answers your Qs:
https://i-base.info/qa/factsheets/pep-faq
hi,i got my first pep pill at hour 71 since exposure.the woman i slept with confirmed that she’s positive.am concerned,will the pep work,ive been taking it consistently.Also i happen to have a mild sore throat since i started taking pep and various mild effects that come and go.could be a sign of seroconversion.,,p.s i havent experienced severe fever or skin rush.
Hi Nsidibe, the symptoms you are have described are too soon to be caused by HIV. Seroconversion (after PEP) is 1-3 weeks after completion. As you had these symptoms prior to this, HIV is not the cause and they have likely been caused by your other conditions.
Also, as your exposure is very low risk this further reduces the likelihood of HIV. Saliva has antiviral properties making HIV transmission via this route very difficult. There has never been a documented case of HIV transmission via oral sex.
Testing after a week is a little early to be sure. You can use a 4th generation test from 6 weeks after PEP to be sure of your result.
Hi,
I started pep about 40 hours after an oral exposure to an Hiv infected person. She was not on medication. Now, 20 days after I started pep, I saw white patches on the roof and inner cheeks of my mouth which I suspect to be oral thrush. Evidently, the lady had vaginal yeast infection.
However, 3 days after completing my pep medication, I developed muscle pain in my groin area and swollen lymph nodes behind my ear and in my neck 6 days after the completion of my 30 days pep. Also, I discovered a swollen uvula without any accompanying pain or difficulty in swallowing. Just the discomfort.
7 days after the completion of pep, I tested negative and I am worried if these are the signs of seroconversion or that of oral thrush as I don’t have any other symptom.
I also tested positive for malaria and typhoid fever 7 days after pep.
Nsidibe
Hi Garth, as you have had the flu it suggests your enlarged lymph nodes are a result of flue rather than HIV. In this instance there is no concern to be worried. You will be able to test using a 4th generation test 6 weeks after finishing PEP. This will then give you a conclusive result.
Hi, josh I am not sure what meds for the flu medication was given but currently I have only glands that are swollen under my jar should I be worried as I am diabetes type 2.