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 David, no this is not a sign of seroconversion. These signs would not appear until after PEP when HIV is no longer being suppressed (if PEP has failed).
More information about PEP can be found here: https://i-base.info/qa/factsheets/pep-faq
Hi Josh,
It’s around 26-27 days post pep.
Now I have discovered another Lymph node around SCM muscle. It’s not large enough, I think tiny like a grain but yes it can be easily felt. Beside this there are no other symptoms. I have a pimple in ear on same side.
Can this be possible seroconversion?
Hi David, no what you are experiencing are not signs of seroconversion. Any signs of seroconversion would not present this soon after PEP.
Overthinking/stress can cause the symptoms you have mentioned. This in addition to the cut/infection you have already mentioned which can also contribute to this.
Hi Josh,
Thanks for your comforting reply.
It’s day 4 after completing PEP. I feel like tightness around my jaw lines near the neck. I think it’s nodes/Submandibular nodes. Although I couldn’t find anything swollen/tender.
I feel like my mouth is dry or Globus.
Can this be seroconversion/Overthinking causing these symptoms?
Hi David, as you have mentioned the most likely cause for the enlarged submental lymph nodes is the infected cut. Signs of seroconversion, if PEP fails, does not present until after the course is complete.
More information about testing and transmission can be found here: https://i-base.info/guides/testing
I had a condom break during sex with a Sex Worker. I started my PEP in 44hrs (1 Dose Darunavir/Ritonavir) & 53hrs(Truvada – Tenofovir/Emtricitabine) I got a cut while trimming on 4th day of PEP. Now this got infected as per me formed some carbuncles(group of boils). Now on 26th day, I observe my submental lymph node(Lymph node below chin) swollen. Could this be due to PEP failure or these Carbuncles as they are nearby these carbuncle was swollen – watery pus but not exactly at lymph node. Really frightened. Please help/suggest – what could this mean?
Hi David, no this is not a concern. Signs of seroconversion would not present while still on PEP.
As you have completed a course of PEP it means your risk of HIV transmission is very low. You do not need to be worried.
More information about PEP can be found here: https://i-base.info/qa/factsheets/pep-faq