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Author Topic: HIGH HIV EXPOSURE AND UNDERDOSAGE OF RETROVIR  (Read 1980 times)

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Offline Bigsasy

  • Member
  • Posts: 4
HIGH HIV EXPOSURE AND UNDERDOSAGE OF RETROVIR
« on: February 15, 2011, 01:11:17 AM »
Greetings all!

I m still battling to come to terms with this incident that happened. I had high hiv exposure on the night of the 26th December 2010 after condom failure and i only discovered this after i have ejaculated. She tested positive and i tested negative on baseline tests. I managed to get the Dr's prescription the following morning on the 27 th and he presrcibed PEP in 3TC 150 mg twice a day and Retrovir 300 mg twice a day. Unfortunately the dispensary made a terrible mistake of giving me 100 mg Retrovir capsules thinking they are 300 mg. The 3TC was correctly supplied. I started taking all these medicines within 12-13 hours after the exposure. We discovered this Retrovir underdosage on the 9th of January (on the 14th day of treatment) and it was rectified back to normal dosage from that evening.

My nurse friend advised that i should see a Dr again. The Dr extended the same regimen PEP by further 4 weeks on top of initial 4 weeks and added Efavirenz 600. I have about 10 days to go before finishing the treatment and all this waiting is really killing me. I tried to inquiry from several medical people here in South Africa about their perspectives but it looks like their understanding of how this virus work is limited and i just get mixed opinions.

What I would like to find out is what do you think of chances of this medication (considering underdosage of retrovir in the 1st 14 days) giving me protection in case the virus managed to get its way through into the system?

I do understand all the risk factors like wether you are circumsised which i did, the open sores and cuts on the genitals which i have checked and i could not see any. The only worrying thing though being that I had been battling this genital pains for years and the various Urologists i consulted they could only speculate that is the prostatitis and some say it is pelvic floor syndrome which i do not know if inside my genitals this condition could have provided the opening for hic infection. Of course if it is capable of entering through the pee hole down.

I have been checking on the internet for any cases where 3TC was used alone for PEP but I could not find any but I read elsewhere where they said 3TC used alone it has high antiviral activity though the virus tend to develop the resistance to it faster. One pharmacist also mentioned that 3TC was used alone with success as PEP in the olden days which i hope is indeed true as that would provide me with a big hope.Would the extension of this PEP and addition of Efeverenz provide any benefit or it might alraedy been late?

Your expert opinion will really be appreciated.

Offline Matty the Damned

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  • Posts: 12,238
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Re: HIGH HIV EXPOSURE AND UNDERDOSAGE OF RETROVIR
« Reply #1 on: February 15, 2011, 01:21:21 AM »
Greetings all!

I m still battling to come to terms with this incident that happened. I had high hiv exposure on the night of the 26th December 2010 after condom failure and i only discovered this after i have ejaculated. She tested positive and i tested negative on baseline tests. I managed to get the Dr's prescription the following morning on the 27 th and he presrcibed PEP in 3TC 150 mg twice a day and Retrovir 300 mg twice a day. Unfortunately the dispensary made a terrible mistake of giving me 100 mg Retrovir capsules thinking they are 300 mg. The 3TC was correctly supplied. I started taking all these medicines within 12-13 hours after the exposure. We discovered this Retrovir underdosage on the 9th of January (on the 14th day of treatment) and it was rectified back to normal dosage from that evening.

My nurse friend advised that i should see a Dr again. The Dr extended the same regimen PEP by further 4 weeks on top of initial 4 weeks and added Efavirenz 600. I have about 10 days to go before finishing the treatment and all this waiting is really killing me. I tried to inquiry from several medical people here in South Africa about their perspectives but it looks like their understanding of how this virus work is limited and i just get mixed opinions.

What I would like to find out is what do you think of chances of this medication (considering underdosage of retrovir in the 1st 14 days) giving me protection in case the virus managed to get its way through into the system?

I do understand all the risk factors like wether you are circumsised which i did, the open sores and cuts on the genitals which i have checked and i could not see any. The only worrying thing though being that I had been battling this genital pains for years and the various Urologists i consulted they could only speculate that is the prostatitis and some say it is pelvic floor syndrome which i do not know if inside my genitals this condition could have provided the opening for hic infection. Of course if it is capable of entering through the pee hole down.

I have been checking on the internet for any cases where 3TC was used alone for PEP but I could not find any but I read elsewhere where they said 3TC used alone it has high antiviral activity though the virus tend to develop the resistance to it faster. One pharmacist also mentioned that 3TC was used alone with success as PEP in the olden days which i hope is indeed true as that would provide me with a big hope.Would the extension of this PEP and addition of Efeverenz provide any benefit or it might alraedy been late?

Your expert opinion will really be appreciated.

Well, I think you might have this a little out of proportion.

HIV is a difficult virus to transmit, particularly from HIV positive female to male duing unprotected anal or vaginal sex. That risk is reduced even more when condom breakage is involved as you were protected up until the time the condom broke.

Add to that the PEP, and I think you're likely to come out of all this with a negative test result.

In that sense I don't think it really matters that you received an underdosage of Azidothymadine. Probably you would be alright even if PEP hadn't been administered but I would suspect that the dosage of 3TC has your bases covered. The addition of Efavirenz was overkill.

Your suspected prostatitis would not have increased the risk from this encounter.

I can understand your anxiety but I think you're going to be alright.

Remember that taking PEP resets the window period. You need to test 13 weeks from the end of your PEP regimen.

MtD

Offline Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: HIGH HIV EXPOSURE AND UNDERDOSAGE OF RETROVIR
« Reply #2 on: February 15, 2011, 06:08:37 AM »
Big,

You never needed PEP in the first place and you certainly don't need it for eight weeks.

There's no doubt in my mind you'll test negative over this brief condom break exposure.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Bigsasy

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  • Posts: 4
Re: HIGH HIV EXPOSURE AND UNDERDOSAGE OF RETROVIR
« Reply #3 on: February 15, 2011, 10:11:46 AM »
Thanks for comforting postings and i indeed pray that that is the case.

But I could not take that chance and not be on PEP because anything could be possible.


Offline Andy Velez

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  • Member
  • Posts: 24,913
Re: HIGH HIV EXPOSURE AND UNDERDOSAGE OF RETROVIR
« Reply #4 on: February 15, 2011, 06:10:10 PM »
I do agree with Ann and Matty that you will ultimately test negative.

However you do need to remember that the waiting period is extended by the length of time you were on PEP. So it's 13 weeks after the PEP was completed.

Andy Velez

Offline Bigsasy

  • Member
  • Posts: 4
Re: HIGH HIV EXPOSURE AND UNDERDOSAGE OF RETROVIR
« Reply #5 on: March 24, 2011, 03:05:57 AM »
Just for unupdate!

I have been quite very relaxed and at peace mentalilly since your replies. I m currently on the 4th week after completion of PEP medication and i have been battling this constant headche recently (for a week) and last night i was sweating which is quite very worrying for me. I do nt know if this could be the early symptoms of acute HIV infection.

Ann would you substatntiate on what basis are you optimistic that I should be negative and i did not need PEP? Is it the same reasoning as the first respond? I m really losing sleep now and i can hardly concentrate. I know the answer will only be to test but I m battling to sum up the courage to go and test as i wonder if i would be able to cope with the positive result.

Your comment on these symptomps will be appreciated

Offline Andy Velez

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  • Member
  • Posts: 24,913
Re: HIGH HIV EXPOSURE AND UNDERDOSAGE OF RETROVIR
« Reply #6 on: March 24, 2011, 08:42:33 AM »
Cut out the drama. You don't need courage to test. You can go to get it done with your knees quaking. Once you reach the testing point just get it done. What's the alternative? To drag out the time until you feel courageous about it? Forget abouit that.

We've all told you after evaluating your situation that we expect you to test negative. When condom breakage has been involved I've never known someone to end up testing positive. So cut out all of this carrying on. Or don't. You can make this as hard or as easier for yourself as you choose to.

We still expect you to come out of this ok.
Andy Velez

Offline Bigsasy

  • Member
  • Posts: 4
Re: HIGH HIV EXPOSURE AND UNDERDOSAGE OF RETROVIR
« Reply #7 on: March 29, 2011, 07:00:56 AM »
Just thought i should let you guys that i eventually went for the test on sataturday morning and fortunately for me i tested negative. The PCR test was also done and today (tuesday) the results came negative. I m so relieved and feel like a new born. To all the people managing this forum many thanks for taking your time to go through my post and encouraging replies. It meant a lot to me and i just wish everyone can learn sumthing from this.

Play safe and Thanks

Offline Andy Velez

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  • Member
  • Posts: 24,913
Re: HIGH HIV EXPOSURE AND UNDERDOSAGE OF RETROVIR
« Reply #8 on: March 29, 2011, 08:29:16 AM »
That's very good news to hear, Big. Keep those condoms handy and make sure they are fresh and fit you properly.

Good luck to you.
Andy Velez

 


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