Which medications should one take to prevent HIV infection?

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 suggest you 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,

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.

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.

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.

Thank you.

Hello,

Welcome back to icliniq.com.

I am able to see only the ESR report. Can you upload your herpes report? Did you ever have anything like blisters in your genitals?

Thank you.

Hi,

Welcome back to icliniq.com.

I am able to see only one report attached with this query and that is the ESR (erythrocyte sedimentation rate) report (attachments removed to protect the patient's identity). I am not able to see any other report or scroll down. If your IgG (immunoglobulin G) is positive, then it is indicative of past exposure. If your IgM is positive, then it indicates acute infection. Pertaining to Herpes, the treatment is provided for active herpes infection only.

Thank you.

Hi,

Welcome back to icliniq.com.

I can understand your concern.

Since your PCR report is negative for HIV, we need not worry. The index is just the cutoff value during testing, so do not worry about it. It varies with batch-to-batch testing and the kits they use. It should be within the limit. Do get your blood tested for HIV 1/2 antibodies and HIV PCR the next month. Stay calm and relaxed. You will be fine.

Wishing you good health.

Thank you.

Hi,

Welcome back to icliniq.com.

Sero negative indicates that your serological study is negative for HIV. Do stay calm. The PCR and Western blot tests are very good tests. Since all these tests show negative at this point, there is nothing to worry about.

Thank you.

Hi,

Welcome to icliniq.com.

Yes, I understand your query.

At the time of initial viral replication, the person may suffer from flu-like illness with or without other symptoms like fever and fatigue. During this time, the antibody is not found within detectable limits. We use methodologies like ELISA (enzyme-linked immunosorbent assay), CLIA (chemiluminescence immunoassay), or CMIA (chemiluminescent microparticle immunoassay) since all these are enzyme-based immunoassays to detect the antibodies and certain antigen like P24 antigen. Though PCR is a very good test, very low viral quantities can be missed out at times due to the detection limits. Both viral multiplication and antibody formation varies from individual to individual.

CRP is a nonspecific inflammatory marker, and it increases in many infectious and noninfectious etiologies. We usually do not do CRP for diagnosing HIV infection. It has been more than two months, since your exposure. If your 4th generation tests are negative by now, then most probably there is nothing to worry about. Now, a PCR test can be done. If the PCR test is negative by now, probably there is nothing to worry about. I understand how difficult you are feeling now. The reason why we wait for three months window period is due to various research carried out and their proven outcomes. The seroconversion takes up to three months in various population and it varies with genetic predisposition, immune status, and other factors. Everything will be fine. Stay calm.

Just do your HIV 1/2 antibody assay at the end of the third month or 90 days from exposure.

Thank you.

Hi,

Welcome to icliniq.com.

The side effects can be due to PEP. PEP usually does not interfere with the PCR tests. Several factors cause an increase in serum creatine kinase like exercise, thyroid problems, electrolyte imbalance, and even medications like anti retro viral drugs. Yes, you can do a PCR test earlier (but we cannot regard it as a conclusive result, but still, it is a very good indicator).

You have waited these many days. Just wait for a few more days. By now most of the patients will show positive tests through PCR post-exposure to an HIV-positive source (after 60 days), in case of being positive. In your case, the results are still negative, which indicates that there is no need to worry. We will just wait for day 90 and do our final test.

Thank you.

Hi,

Welcome to icliniq.com.

I acknowledge your lab reports (attachments removed to protect the patient's identity). Creatine kinase is 294 U/L, HsCRP (high-sensitivity C-reactive protein) is 6.08 mg/L, and CRP (C-reactive protein) is 6.73 mg/L. I notice an increase in creatine kinase, HsCRP, and CRP levels. At this point, the increase in creatine kinase could be due to strenuous activity like vigorous walking, psychological stress, and even inadequate hydration. The present season is such that, we may get seasonal flu and other mild illness which could increase the CRP level. Psychological stress is also attributable to an increase in CRP. For now, we will wait and observe. I suggest you do the following:

1. Drink at least two liters of water per day.

2. Keep your mind calm.

3. Have two cups of green tea per day.

4. Take good rest for at least two to three days.

5. Include ginger in your food if you are not allergic to ginger (you can make the ginger extract and add it to butter milk and drink it twice a day) since ginger is a good anti-inflammatory.

I want to know a few more things.

1. Did you have any flu or fever or infections a few days back?

2. Any history of cardiac problems in the family?

3. Are you facing severe psychological stress due to the current scenario?

4. Are you drinking adequate water in a day?

5. Are you doing any workouts or strenuous exercise or walking?

6. Are you facing any joint problems like joint pain in your legs or arms?

7. What is your weight and height?

Please let me know about the above-mentioned queries.

Thank you.

Hi,

Welcome back to icliniq.com.

I am able to see your report (attachments removed to protect the patient's identity). For now, please follow my advice as mentioned earlier. We can follow up with HsCRP, CRP and creatine kinase after two weeks.

Thank you.

Hi,

Welcome back to icliniq.com.

No need to worry. The tests done after a window period of three months are sufficient. Both ELISA and PCR are very good tests and they do not miss HIV 1 and 2. I saw all the lab reports. It is a normal study. HSV IgG denotes past infection only, so do not worry about infection transmission to other family members. Transmission usually occurs only when you have active lesions.

Thank you.

Hi,

Welcome to icliniq.com.

I acknowledge your query.

1. The cutoff you mentioned in the query denotes the cutoff value which is a measure of OD value during the reaction, which happens in all the normal tests. The measurement changes during each test. All the tests are usually done with all the positive and negative control for quality purposes. Do not worry about the index value.

2. There are two types of Herpes simplex virus. Herpes simplex virus type 1 (HSV1) and Herpes simplex virus type 2 (HSV2). Among these, HSV 1 causes infection in pediatric and young adolescents and also to some extent in adults. Your HSV1 IgG is high, which indicates past HSV 1 infection, so there is nothing to worry about (you had the infection before). The only thing is, after the acute infection, the HSV virus stays dormant in the trigeminal ganglia for life long and can get reactivated during any point of life to cause re-infection, but you need not worry. HSV 2 is transmitted through sexual mode but your HSV2 is negative.

3. All the tests which we do, aim to detect both HIV1 and 2 infections. Rapid cards and ELISA detect both types. So, do not worry.

4. To date, we do not have an undetectable HIV. All your symptoms are routine issues, which could be due to climate and nutrition. Do not worry. Have a nutritious meal and a healthy lifestyle.

5. After 90 days of exposure, the viral load will never be low. No need to repeat any more tests.

6. Yes, I saw all the reports. All are within normal limits. Do not worry about hematocrit and absolute cell counts of lymphocyte and basophil count. MCHC (mean corpuscular hemoglobin concentration) and mean platelet volume too are fine, so no issues.

7. You have crossed the window period and you have also undergone good tests after 90 days. So, please do not worry. You can go with your routine lifestyle.

8. Almost everyone including children will get HSV1 infection during their lifetime. So do not worry about it. Your HSV report indicates past infection with HSV 1 only.

The red spots could be due to allergies or skin infections. You can have a consultation with a dermatologist.

I hope my answer is brief and clear.

Thank you.

Hi,

Welcome to icliniq.com.

Glad to have you back.

Your value denotes negative test result only. Do not mind about the value. Since it has been nine months, you have crossed the window period already. You are HIV negative. Do not worry.

Thank you.

Hello,

Welcome back to icliniq.com.

You have crossed the window period. There is no necessity to worry.

Wishing you good health.

Thank you.