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?
Please see this link for more information about PEP:
https://i-base.info/qa/
Josh.
Hi Kumar, as you had used a condom (before it broke) and started and completed a course of PEP within 6 hours you have a low risk of transmission.
Even if PEP fails, seroconversion would not present during the course. This is because PEP would still suppress HIV preventing seroconversion. This suggests that the symptoms you had while on PEP were not a result of HIV. PEP does not prevent against other common infections that can cause the same symptoms e.g., a cold, covid or the flu.
What you are experiencing after PEP is also too soon. Symptoms of seroconversion would not present until at least 2 weeks after your last dose of PEP.
Please do not start treatment now. Starting treatment early can lead to delayed confirmation of your status. Starting early does not offer further benefit to your health when you are unsure of your status.
For more information about testing and transmission please see here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
This case will became positive or not you contact it.
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?
Hi Kasaya, no this does not confirm PEP did not work. There are multiple causes for the symptoms you have mentioned and as you completed a course of PEP with already a negative test, it makes your risk of HIV very low.
An antibody test will be conclusive from 90 days after the last dose of PEP.
A painless rash that disappeared so quickly does not suggest HIV.
For more information please see here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Hello doctor.
Today is my 50th day after the last PEP dose. I tested negative on day 44 after the PEP last dose using antibody test, the result was negative. As I am typing now, I have fever throughout the body, lymph node under my right armpit is swollen and is painless. I have experienced night sweats two days ago. I was exposed to HIV after the condom torn. The woman was positive for HIV. I started PEP after 10 hours of the exposure. PEP lasted for 28 days. On day 26th before PEP ended, I developed few red round rashes on my hands and legs. They were painless. They later on vanished on their own. Does this confirm PEP did not work?
Hi Juma, for more information about transmission please see here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Hello and how are you today? I had unsafe sex with a HIV positive woman who is currently on ARVS. The unsafe sex came immediately after the condom failed to work, ruptured. The second and the third rounds we played without having condom on. On the following day, I rushed for PEP from a nearby hospital.
I completed PEP 10 days ago and I have been experiencing burning sensation in armpits then in the thighs.I have also been experiencing irritating throat for a bout 8 days and nose blocking one at a time. I also developed one rush on the head of my penis, it was painless and disappeared own its own after 3 days. Prior to completing the PEP, that was on the 27th day, I developed red rash on the legs and few on the thighs. It took them 3 days to disappea. Are these the early symptoms for HIV in the my body?
I am worried#
Hi David, for information about PEP please see here: https://i-base.info/qa/factsheets/pep-faq
Thank you for the reply. Today is my 10th day after the last dosage of PEP. Right now I am experiencing burning sensation under my armpits. Sometimes the burning sensation attacks the thighs and sometimes the waiste line. What’s the meaning of this, is this about seroconversion?
Hi David, no this does not mean PEP has failed. As your partner had been on treatment it remains likely that she had an undetectable viral load meaning transmission would be impossible. Even if she had a higher viral load, being on treatment usually means there is no recommendation for PEP.
Furthermore as you had started PEP so soon after this potential exposure it makes the likelihood of these symptoms being caused by HIV VERY unlikely. These symptoms are very common and can be caused by many other common infections e.g., a cold, flu or even COVID.
As for the rashes, are they still there? and when you noticed them had you been leaning on these areas? If these rashes do not go please speak to a doctor to have them checked.
The condom broke in the middle of sexual act. The lady is already HIV positive. And she’s on ARVS treatment plan. Although I don’t know how consistent she takes the ARVS. I started immediately taking the PEP and that’s was after 10 hours of the exposure. On the 14th day, I developed a slight itchness in my throat. I also developed a small cough which was accompanied with phlegm any time I coughed. It then went away on its own. Sometimes the slight itching in my throat comes and at a times not. Now, on the day 27th, I have noticed I have developed few red rash on legs and on one of my thighs. The rash are none itchy. Could this mean the PEPs failed on their mission??? My PEP ends on day 28th.