Question
Did PEP work?
3 April 2023. Related: All topics, HIV transmission, PEP/PEPSE.
Hi there!
I have sex with a sex worker and the condom failed. I am unsure of her HIV status. However I stated PEP around 40 hours after the exposure.
The PEP I was prescribed was Tribuss. I am worried that this was the incorrect PEP to be given due to drug resistance.
Anyway I found out I got chlamydia during this exposure. I completed the PEP and a course of Doxycycline for the Chlamydia. Then the day after I finished the two weeks Doxycycline, I started getting a white tongue. I also believe I have muscle aches however they are not painful. The white tongue and muscle aches started 10 days after finishing PEP.
Also on the 10th day I did a self test blood antibody test, which came back negative. I will test again on day 40 after the last does of PEP, but I am very worried about these symptoms.
Will the Tribuss work? Should I be worried about these symptoms? Thanks,
Steve
Answer
Hi Steve, how are you doing?
Why do you think there is drug resistance? Atripla is not recommended as PEP. This is more a result of the potential side effects of Atripla rather than its ability to prevent HIV transmission.
Atripla contains efavirenz. This drug can cause mood disturbances which is the reason it is not offered as PEP. As you have completed the course of Atripla for at least 28 days Atripla would have still been able to prevent HIV transmission.
Is there a reason you think this sex worker is HIV positive?
A white tongue can be caused by doxycycline. The antibiotic can put you at risk for other infections while you are taking the course. Have you mentioned this to your doctor?
Have you noticed any other symptoms aside from the muscle aches? and if they are not painful do you know anything else that could have caused this e.g., more exercise, increased tiredness, dehydrated?
A self test antibody test is only accurate from 90 days after the last dose of PEP. You can use a 4th generation test. These look for antigens and antibodies. These tests will be accurate from 42 days after the last dose of PEP.
You should not be worried about the symptoms you have in relation to HIV. The white tongue is likely explained by doxycycline and muscle aches are common and alone they do not suggest HIV.
Josh.
Hi Bbbb, all previous answered questions are still up. They will either be posted as standalone questions or in the thread of a comment.
Hello
Where can I see the answers to my previously asked questions
Regards
Hi Josh,
I would like to update you and the thread on this one.
I have now got back from my work trip and on the 10th week since my last does of PEP I tested negative on a Sure check HIV test. I actually had an insanely faint line in the positive mark.
This followed with a negative test result on the 11th week also with a sure check quick hiv test.
Then also on the 11th week I had a test done in the UK by the NHS’s freetest.me service, they used an AG/AB test that they claim is near 100% effective after 8 weeks. This also came back non-reactive.
I do still have the same symptoms talked about before so I’m going on the hunt for what could be causing these symptoms.
I believe I can now rule out HIV however I have learnt so much about HIV during this experience, from being very naive about the infection to now being far more aware. This experience has also made me think twice about my drinking problem of getting insanely intoxicated and learn to be more in control of my actions.
For anyone reading this, stay with an upbeat attitude for what ever your result may be, or ongoing life of living with HIV. Thank you Josh and Simon for everything I really appreciate the service you offer (even though I did not use it correctly and wasted your time for people who are actually living with HIV).
hi Steve, yes Trisbuss is still likely to work. Starting PEP within 72 hours is effective.
Hi Josh,
No I have not spoken to a doctor regarding any of my symptoms, to be honest I am holding off on confronting the issue for the time being as I feel I know what the outcome will say.
I will be speaking with a doctor and testing next week… is Tribuss likely to still work if taken as PEP at the 40-45 hour mark after exposure? im very disappointed in myself and know this will make a huge change in my life either if i test positive or negative.. I am seeing too many Acute symptoms now to feel any comfort in testing!
another symptom im having is mouth sores. nothing too bad however maybe more than usual, great i will just add this to the list! My body certainly doesn’t feel right.
Regards
Hi Steve, I can understand why you are worried but it is impossible to say the cause of your symptoms without testing. Have you spoken with a doctor about any of your ongoing symptoms? As you have said it is still more likely that these have been caused by stress, PEP or your other medication. HIV still remains as the least likely cause.
hi Josh,
Thanks for answering on a Saturday!
All the symptoms I have been having are changing, such as most recently I have started to feel un-comfort in my abdomen. This has been happening for around 6 days now. I would not define it as pain however its more like cramps and general un-comfort, this is not in one particular place.
My lymph nodes have only started to swell roughly 10 days ago, they are still swollen.
Where as the white / hairy tongue started about 6 weeks ago followed by the muscle aches maybe 5 weeks ago.
I finished pep almost two months ago now.
I am obviously very stressed and trying to pass of my symptoms as effects from PEP, Doxycycline, stress etc. But i am aware the only way to know for sure is taking a test. Which is very worrying indeed!
Hi Steve, can you explain what you mean by your symptoms changing? Over a period of 6 weeks it is normal for symptoms to change/improve as your body is getting better over time.
Hi Josh,
Thanks as always for answering all my questions.
Is it normal for Acute Symptoms to evolve and change over a period of 6 weeks or so?
I will be going for a test shortly, I am just preoccupied with work currently. I am also very worried to get the results I am dreading!
I know something is not right with my body.
Thanks,
Steve