Dr. Ravinder K. Sachdeva
HIV/AIDS specialist
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I had an intimate encounter with someone whose HIV (Human Immunodeficiency Virus) status is unknown to me. We had no intercourse, but somehow I swallowed two to three drops of milk since the girl was lactating. She had a year-old child. I read that mother's milk carries HIV. In a panic, I consulted multiple doctors online, and one recommended the tablet Viraday as PEP(Post-exposure Prophylaxis). I started it within 26 hours out of fear. Most of the articles that I had read online say there has never been a case of an adult getting infected like this. But, the doctor who recommended this said he had seen cases. I asked another doctor, and he said that I am at negligible risk until and unless I have open wounds in the oral cavity, but out of panic, I started taking the tablets. It has been four days now. I feel sensations and dizziness. Today I felt palpations at my back, just below the hand and shoulder joint. Can you let me know whether the medicine is dangerous and if am I at risk of getting HIV?
Hello, Welcome to icliniq.com.
I would like to share a few facts which are important to conclude - A mother who is lactating with HIV (human immunodeficiency virus) can transmit HIV to a newborn if the mother has not received sufficient antiretroviral therapy during pregnancy and postpartum (post-delivery). Risk of transmission during breastfeeding depends on so many factors: whether HIV therapy is being received, duration of lactation, if on therapy, viral load, and presence of other infections. Quantity of body secretions exposed is another important factor. Ingested amount as per the case description is insufficient for HIV to transmit. Dizziness could be due to tablet Viraday [600 mg Efavirenz (EFV), 200 mg of Emtricitabine (FTC), and 300 mg of Tenofovir disoproxil fumarate (TDF)]. Before starting tablet Viraday, have you undertaken a baseline HIV test for yourself? There are a few side effects with medicine, one of which you mentioned in the form of dizziness. However, serious side effects are on rare occasions.
I hope it helps you.
Thank you.
Patient's Query
Hello doctor,
I did not get tested for HIV since I started the PEP within 26 hours of exposure, and I understand that tests are to be done after 28 days. Also, since you say the quantity is insufficient to cause a transmission, shall I continue with Viraday or stop? I have taken only five doses. I am very concerned about its ill effects on the liver, kidney, etc. Some say that Viraday is a kind of chemotherapeutic drug only. And if I intend to continue for 28 days out of panic, can I think about it? Is it okay to have the tablets even if I do not have any infection inside my body? I am sure there will be side effects. But is it not better to take medicine than risk infection? I could not find the real side effects of Viraday online; hence I am confused.
Hello,
Welcome back to icliniq.com.
I suggest you first get a baseline HIV rapid test. This helps you to know HIV status prior to exposure. Tests performed at 28 days following exposure would help you know the probable status after exposure, and the confirmatory HIV test is recommended three months after exposure. Efficacy of PEP (post-exposure prophylaxis) is only when taken adequately, as advised for 28 days. Irregular intake is not advisable. Medicines have few side effects. The majority of these are reversible (revert to preexisting state after stopping). The remaining facts have also been provided in the previous answer.
Thank you.
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HIV/AIDS specialist
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