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Author Topic: HIV PEP - Missed Doses  (Read 964 times)

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Offline freedie

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HIV PEP - Missed Doses
« on: May 19, 2014, 03:29:23 PM »
Hi,

I had an unprotected Sex with an Indian SexWorker in Delhi, India. It was late in night so couldn't contact a doctor.
I went to pharmacy and purchased Truvada & Kaletra.
Within 7 hours I took my first dose of Kaletra at 2:00 am.
In Morning 6:00 am I had a flight & came in different country with language barrier.
Second Dose: 4 pm (Kaletra+Truvada)
I fell ill/sick and after that
Third, Fourth & Fifth Day I took only Truvada Only.
Sixth Day onwards I am taking 2 Kaletra & 1 Truvada.

Untill I realized PEP regimen is 1 Truvada and 2 Kaletra (Twice a day), makes it 4 Tabs a day.
Today is 10th Day.

1. Will it make sense to start 1 Truvada and 4 Kaletra a day or just 1 truvada & 2 Kaletra a day are sufficient?

2. Is there any test I can take up right now.
Pls. Advise.
 

Regards
Fred
« Last Edit: May 19, 2014, 03:31:24 PM by freedie »

Offline Andy Velez

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Re: HIV PEP - Missed Doses
« Reply #1 on: May 19, 2014, 03:32:33 PM »
Freedie, if by unprotected sex you mean intercourse, then yes, you were definitely at risk. You should not be self-proscribing. I suggest you see a doctor and discuss what you've done so far and how to proceed at this point.

Andy Velez

Offline freedie

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Re: HIV PEP - Missed Doses
« Reply #2 on: May 20, 2014, 01:58:30 PM »
Yes,

It was intercourse.
What are the chances from a woman to man ?
I'm in a country with language barriers.

Luckily I managed to get the medicine on time.
Standard PEP Regimen.

I'm worried about the missed doses.

Regards

Offline Joe K

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Re: HIV PEP - Missed Doses
« Reply #3 on: May 20, 2014, 02:04:00 PM »
Fred,

Nobody can estimate your chances of contracting HIV.  Same with any missed doses of PEP.  What you need to do is to complete your course of PEP, wait six weeks after you end PEP and test.  You can then test at 3 months, since stopping PEP to confirm the result.

Until you complete the PEP and test, six weeks later, there is no way to know your status before that time.

Joe

Offline freedie

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Re: HIV PEP - Missed Doses
« Reply #4 on: May 20, 2014, 03:04:13 PM »
Agreed.

Which is why I'm scared.
I missed only kaletra.
Truvada I have taken everyday.

Hopefully it was better than missing both.
I wish  was not travelling that time.

Anyway!
Hopefully there is less risk.
I'll update post PEP

And thanks to this community.
You Guys are doing Noble Job.

May there be a cure of hiv/aids one day.
May that day come soon.

Amen!


Regards


Offline Ann

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Re: HIV PEP - Missed Doses
« Reply #5 on: May 21, 2014, 03:24:00 AM »
Freedie,

Hiv is a fragile, difficult to transmit virus and it's more difficult to transmit from a woman to a man (receptive partner to insertive parter). You are unlikely to end up hiv positive from one instance of unprotected, insertive intercourse, PEP or no PEP.

In a low risk case like yours Truvada on its own is effective, so stop stressing out over your missed Kaletra doses. Just keep taking at least the Truvada until you have taken it for 28 days.

As Joe said, taking PEP increases your testing window by 28 days (four weeks, the amount of time you take PEP). This means that the earliest you should test is at six weeks post PEP. You can test again for a conclusive negative result at three months - twelve weeks - following your last dose of PEP.

You really should have been tested for hiv BEFORE initiating PEP as that is standard protocol. If you were already hiv positive before having unprotected intercourse with the sex worker, you could be setting yourself up for drug resistance. Just because you can buy these drugs without consulting a doctor doesn't mean it's a good idea or the right thing to do. You could be causing yourself serious harm going it alone.

If you actually were unknowingly hiv positive BEFORE this incident, you would still test positive on an antibody test even while taking PEP. (Poz people who are on treatment still test antibody positive.) This means you can still test to check if you were already poz.

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 freedie

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Re: HIV PEP - Missed Doses
« Reply #6 on: May 21, 2014, 01:03:17 PM »
Thanks,

What tests will that be?

HIV 1 & 2 ANTIBODIES, SCREENING TEST with p24 Antigen
or
HIV 1 RNA QUANTITATIVE, REAL TIME PCR
or
HIV 1 & 2 ANTIBODIES, WESTERN BLOT

Will get tested tomorrow only?

Are there any tests for shorter duration after I complete my PEP then 6 week. If yes pls. tell me.


Regards
Fred

Offline Jeff G

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Re: HIV PEP - Missed Doses
« Reply #7 on: May 21, 2014, 01:08:28 PM »
The standard antibody test is the correct one . You can test 6 weeks past any possible exposure and past pep and again at 3 months to confirm it . There are no shortcuts to testing and they MUST be confirmed at 3 months .   

Offline freedie

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Re: HIV PEP - Missed Doses
« Reply #8 on: May 21, 2014, 02:42:55 PM »
first one?
HIV 1 & 2 ANTIBODIES, SCREENING TEST with p24 Antigen
 or something else?

Offline Ann

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    • Num is sum qui mentiar tibi?
Re: HIV PEP - Missed Doses
« Reply #9 on: May 21, 2014, 03:06:02 PM »

HIV 1 & 2 ANTIBODIES, SCREENING TEST with p24 Antigen


That one.


Will get tested tomorrow only?


Testing tomorrow will only tell you if you were already hiv positive before you started PEP - and at least six weeks before your recent unprotected intercourse with the sex worker.

The only reason you would need to test tomorrow is if you didn't have a rapid test before starting PEP. I'm assuming you did NOT have a rapid test before starting PEP because you did not see a doctor to get PEP, you took matters into your own hands and bought PEP at a pharmacy.

Standard protocol before putting a patient on PEP is to test them with a rapid test first, to make sure they're not unknowingly already hiv positive.

There are no short-cuts to hiv testing after a risk or after taking PEP. I've already given you the testing window period guidelines and so has Jeff.

DO NOT use PCR tests - any result from a PCR test must still be confirmed with standard antibody testing. PCR tests are NOT diagnostic tests.

Western Blot tests are only used to confirm a positive result on a standard antibody test. You do NOT need to test with a WB unless you test antibody positive. WB tests rule out false antibody positive results - which do happen from time to time.

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 freedie

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Re: HIV PEP - Missed Doses
« Reply #10 on: May 22, 2014, 06:21:44 AM »
Hi i have got the results.

HIV 1 & 2 ANTIBODIES SCREENING TEST, SERUM  @
HIV 1 / 2 & P 24 COMBO TEST
(CMIA)
Index Value 0.09

Interpretation
 --------------------------------------------------------
| RESULT IN INDEX        |         REMARKS               |
|------------------------|-------------------------------|
|    < 1.00              |      Non Reactive             |
|------------------------|-------------------------------|
|    >= 1.00             |     Provisionally Reactive    |
 --------------------------------------------------------
Comments
Non  Reactive  result  implies  that  antibodies  to    HIV  1 /  2 have  not  been  detected  in  the  sample.This  means  the patient  has  either  not  been  exposed  to  HIV  1 /  2 infection  or  the    sample    has    been  tested  during  the  "window phase"  i.e.  before    the    development  of    detectable  levels of  antibodies.  Hence  a  Non  Reactive  result  does  not exclude the possibility of exposure or infection with  HIV 1 / 2.

Offline Ann

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    • Num is sum qui mentiar tibi?
Re: HIV PEP - Missed Doses
« Reply #11 on: May 22, 2014, 06:47:44 AM »
Freedie,

Good news. Your results mean that you did NOT have hiv before you put yourself on PEP.

Now just keep taking at least the Truvada for whatever is left of the 28 days and you'll stay hiv negative. You can take the Kaletra as well, but make sure you definitely take one Truvada pill each day.

You're going to be just fine - provided you learn from this and stop having unprotected anal or vaginal intercourse with ANYONE until you're in a mutually monogamous relationship where you've BOTH tested hiv negative together.

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 freedie

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  • Posts: 7
Re: HIV PEP - Missed Doses
« Reply #12 on: May 22, 2014, 08:55:12 AM »
The Only thing that haunts me is that I had two unprotected exposures of insertive vaginal in mid of april & last week of april.

So, it's sort of scary right now.

But, Yes I've learnt a lot.... If I come out of this safely  which I hope, wish & pray I will .... I'll repay the good luck to mankind by educating them & supporting them in whichever way I can.... Now I respect everything & everyone ....

I really Hope, Wish & Pray to GOD ... that there soon be a cure for those who are positive.... May there be soon.

Amen!

 


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