Question
I switched PEP…
27 July 2022. Related: All topics, HIV transmission, PEP/PEPSE.
Hi, I hope this finds you well. I have got a question with regards to PEP.
So I had an exposure to HIV and immediately started PEP (Truvada alone) within 12 hours after exposure. I again visited a healthcare and my treatment was changed to Acriptega (TLD). This was after 55hrs of exposure.
I wish to know the chances of seroconversion for I have developed swollen lymph nodes on the neck on my 10th day. I have been adhering to PEP treatment without failure. I am really worried.
Answer
Hi, how are you doing?
As you started PEP within 72 hours, it is most likely to work. This is regardless of you switching the type of PEP you were on at 55 hours.
While not the most effective, a 2 drug combination like Truvada is still used as PEP and is shown to be effective. Switching to TLD within the time frame is only going to improve how well your course of PEP works.
How risky was your HIV exposure? Chances for seroconversion are low given you started PEP so soon.
Swollen lymph nodes can be a sign of a number of infections. HIV being much less likely than a common cold or even COVID. Have you experienced any other symptoms? A swollen lymph node alone is not enough to be suggestive of HIV.
Josh.
Hi Josh,
Thanks for your support.
I’m in the last week of PEP. Most of the symptoms have gone. But I think I still have the lymph node swollen, probably because I keep poking it every hour.
Do you think, this should concern?
How likely it is to catch the infection?
Hi David, you have developed this lymph node too soon after an exposure for this to be HIV related.
As you started PEP within the recommended time frame, even if PEP fails (which is unlikely) you will not experience symptoms of seroconversion until AFTER PEP is complete. Your current symptoms have not been caused by HIV.
You have mentioned that this is possibly a side effect of PEP. How bad is the pain/have you experienced this before? If the pain continues/does not improve please speak with your doctor about possible causes and how to treat. Keep aware if you notice any other symptoms that could be a side effect of PEP.
You will be able to confirm your status from 6 weeks after the last dose of PEP using a 4th generation antigen/antibody test. More information about testing can be found here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Hi Josh,
I had sex with a sex worker. Unfortunately, the condom broke. I started Ritonavir/Darunavir on 44 hours & Tenofovir/Emtricitabine at 50 hours at night.
After around a 5-6 days, I developed a enlarged lymph node on my neck. Now, it’s 2 weeks & it hasn’t settled. I have been on this regime for around 2 weeks now.
I have joint pain & abdominal pain too which some suggest might be a side effect of PEP.
Can this enlarged lymph node mean HIV has reached my lymph node.
Hi Blessed, is your partner on treatment?
While on PEP signs of seroconversion of delayed. You can still get common infections like the cold which will cause the same symptoms.
For more information about PEP please see here: https://i-base.info/qa/factsheets/pep-faq
hello. wanted to enquire about PEP medication. i was exposed to HIV by my partner she had not talked to me about her status. we didnt practise safe sex and only told me during our second encounter after 10 days of the first exposure. i then went to a clinic where i tested negative and was started on PEP for my second encounter but however thay explained the risk of the first encounter. i had a diarrhea 10 days after my first encounter that lasted like 4 days, and after i started taking my PEP medication around the 14th day i developed a swollen node under my right armpit. Could it be the infection or due to the medication im taking please help. Also i was circumcised 2 years earlier will this help in my fight.
Hi France, no this will not change the efficacy of PEP.
As you have still been taking a form of PEP each day, the change in treatment will have no impact on how effective the course of PEP will be.
Good day Josh. I hope this finds you well
I was switched from Trenvir to TLD on my 2nd day of PEP due to side effects of Efavirenz(i took trenvir in the morning 10am and switched to TLD same day at 14h00, then continued TLD everyday at 14h00) . Will this affect the efficacy of Pep?
Hello Josh,
We did test and she was positive. I have had swollen lymph nodes, sore throat, headache and a bit night sweat. It’s my 3rd week now. It’s taking a toll on me. Anyway I guess I have to wait and complete my therapy and test.
Hi Kink, in this case it is still much more likely that your partner was HIV negative.
In this period waiting for testing, stress can also cause symptoms that mimic seroconversion. This is a link about dealing with fear and anxiety around testing: https://i-base.info/guides/testing/hiv-testing-feelings-of-fear-anxiety-and-guilt
Hello Josh,
I am doing alright.
Thank you so much for your response.
I would term it as high risk given that the other party was not aware of her status so she was not on any medication and we never practiced safe sex. Lesson learned
So far I am only experiencing a swollen lymph node and some discomfort in my throat. No other symptoms. I tested negative for Covid last week too.