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Q. Which medications should one take to prevent HIV infection?

Answered by
Dr. N. Ashok Viswanath
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 22, 2022 and last reviewed on: Sep 23, 2022

Hello doctor,

I am a 33-year-old male, I recently had unprotected sex with one paid sex worker, and I noticed bleeding on my penis frenulum during sex. So after 11 days, I got her tested for HIV. One report was negative, but another report was positive. Her HIV 1 RNA shows 51 copies, so what could be her viral load 11 days back? Currently, I am taking tablet Trioday and tablet Udiliv 600 mg. Shall I take it for 28 days or 30 days? HIV 1 PCR report shows undetectable viral load after two weeks of Trioday. Shall I get tested again? Kindly help.

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#

Hello,

Welcome to icliniq.com.

Thank you for your query.

I understand your concern. I reviewed your reports (attachment removed to protect the patient's identity).

Can you send the PCR (polymerase chain reaction) of your partner?

The load of 50 copies of HIV (human immunodeficiency virus) RNA (ribonucleic acid) indicates less viral load, so the chance of transmission is low. But still, as you had unprotected sexual intercourse with bleeding from the frenulum. So I will suggest you to continue the medication for 28 days.

At the end of the third and sixth months, get your blood tested for HIV 1/2 Ab test using ELISA (enzyme-linked immunosorbent assay). You can also go for P24 antigen & PCR testing after completion of the treatment course.

I understand your level of anxiety at this moment, Do not worry. As you are on post-exposure prophylaxis and the viral load looks very low. The chance of transmission of HIV infection is significantly less. But still, complete the dose and get your blood tested, as I mentioned.

I hope this has helped you. Thank you.

Hello doctor,

Thank you for your reply.

I have attached three reports of her.

I want to know whether tablet Trioday is a good PEP medicine.

Thank you.

#

Hello,

Welcome back to icliniq.com.

I understand your concern. The report suggests (attachment removed to protect the patient's identity) that the woman is likely to be in a window period. Since the viral load is significantly less, the chances of infection transmission are very low. Since you have started tablet Trioday (antiretroviral), please continue it and complete the course. This time, there is no rationale to change the post-exposure prophylaxis regimen. Tablet Trioday is an old regimen, but it is still good and has good antiretroviral activity and effectiveness.

I hope this has helped you. Thank you,

Thank you doctor for the reply,

I finished taking the tablet Trioday a month ago. I had fever, sweat, and chills at night, and since then, I have had muscle pain and joint pain. I am so worried now and cannot even breathe. Are these symptoms of anxiety or stress? I tested today for the fourth generation, but it came negative. Also, I have tested for HIV 1 RNA by PCR, which is also undetectable. Am I in the seroconversion period, and test results are delayed because of PEP? Her viral load was 51 copies after 11 days of exposure to me. So will it be considered untransmittable? Is there a chance of transmission because there was a cut on my frenulum?

#

Hello,

Welcome back to icliniq.com.

I understand your questions.

It could probably be due to your stress. We cannot tell if this fourth-generation test is right or wrong since it can come negative in the window period (exposure after three months). The test result will not change due to post-exposure prophylaxis. The first three months or window period is the seroconversion period. Right now, I cannot comment on whether you are in the seroconversion period. A viral load of 51 copies per mL can not be considered untransmittable. For a known case HIV (human immunodeficiency virus) positive patient who is on proper anti-retroviral medication, its undetectable test result denotes an untransmittable scenario. Here, 51 copies per mL denote much less viral load, so there is less chance of transmission.

Thank you doctor for the reply,

Will her viral load be less in ten days? Currently, her viral load is 51 copies per mL, but the viral load should increase much more in ten days, and if she was infected, the value should be quite high. Please elaborate and make me understand this point. If my fever and joint pain symptoms are of early HIV, then should it be detectable in current test results? Shall I take one more test immediately? Is it tough for me to wait for three months?

#

Hello,

Welcome back to icliniq.com.

The viral load could probably be low ten days ago, but it depends on the individual status and immune response, which tends to vary. I suggest you test your blood for HIV (human immunodeficiency virus) PCR (polymerase chain reaction) from the 45th day from day of exposure. I do not think you will get the infection by looking into the viral load and your post-exposure prophylaxis. Stay calm. I can understand the level of anxiety you are going through right now. The final blood test is to be done after three months after exposure.


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