Starting Truvada as a PEP

[glam89]

I've just been prescribed Truvada as a PEP regiment by my local clinic. I am a female that had unprotected sex with a man of unknown status (he pulled out last sex). Its been 36 hrs since incident and i just picked up the pills from my pharmacy. I'm very nervous about actually starting them because I'm very fearful of liver and kidney damage, I've always been kind of a heavy drinker to make matters worse so my liver is not in the best shape. The doctor that prescribed Truvada didn't seem very knowledgeable about PEP, she isn't even going to monitor me while i am taking the pills or give me any tests before hand, she just told me to come back in 4 weeks to take an HIV test. Is this a normal thing that they usually do? Or should i go to an ER to speak to someone about this?

[Andy Velez]

Side effects are less like to be an issue with Truvada, which is a combination of entricitabin and tenofovir.

The key element for success with PEP is the earlier it is started after a risky incident the better the chances it will do the job.

You can test with your doctor when you complete the 28 day cycle, but in order to get a conclusively negative result you need to re-test at 3 months after the completion of PEP.

You'll most likely get through it without any really problematic symptoms, but obviously if you have what you consider severe reactions then you should call your doctor.

Meantime you need to focus on other matters in your life so that you get through the waiting time as easily as possible.

[glam89]

I took the Truvada so far the side effects are that I have a huge headache, very tired, and kind of nauseous but that's all normal though, right? Am i allowed to take any over the counter medications? I don't remember the doctor giving me any information on that. Surprisingly the symptoms aren't that bad so far, i expected much much worse. I could compare these side effects to the effects of when i first started taking antidepressants.

[glam89]

Also would it be possible to ask the Dr to check for creatinine levels for kidneys and a liver function test even if they don't have any numbers to compare it to after i finish the Truvada? Would they still be able to tell if it did any damage?

[jkinatl2]

Over the counter drugs will not interact with Truvada. Nor will one month of the drug make a discernible difference in your liver/kidney levels other than perhaps a mild spike which will almost certainly disappear.

The kidney and liver damage is almost exclusively limited to those who have taken Truvada for an extended period of time (years.)

Given the relative low end of the spectrum risk you described, along with PEP, I think you will be ok.

[Ann]

The doctor that prescribed Truvada didn't seem very knowledgeable about PEP, she isn't even going to monitor me while i am taking the pills or give me any tests before hand, she just told me to come back in 4 weeks to take an HIV test.

Glam,

You should have been given a base-line rapid hiv test before you were given PEP, in case you are already hiv positive and just don't know it. If you were not given this base-line test, perhaps you should get in touch with that doctor's supervisor to complain and suggest the doctors in that hospital (or clinic or where ever you went) get themselves up to date on PEP prescribing protocols before prescribing PEP.

There's no point in testing at four weeks when you finish the PEP. Taking PEP extends the window period by four weeks, so this means the earliest you should test post-PEP is at six weeks. A negative result at six weeks post-PEP is highly unlikely to change, but must be confirmed at the three month (post-PEP) point.

I agree with you - this doctor seems to know very little about hiv testing or PEP protocol. Sounds like you need to find a doctor who isn't willing to prescribe strong medicines he or she knows nothing about.

Ann

[glam89]

Thanks Ann.
I had a rapid test done a week before during a physical exam and that came out negative but then this incident occurred so i guess the Dr decided I didn't need another test?
I called and spoke with a HIV specialist to see if i would get better information than the Dr who prescribed me the PEP but she told me to come in for testing after 2 weeks even though I'd still be taking PEP and then another test at 4 weeks. So I'm not sure as to why she would tell me to do this if PEP just extends the window period.

Also I don't know if this is a side effect from the Truvada but I've developed what appears to look like small circular redish/brownish bruises ALL over my legs. Its not bumpy or itchy, it just looks like my legs took a bad beating.

[glam89]

Is it normal to get some kindey pain or should i be going to the hospital right now? It feels like someone is kicking me in my kidneys every 10 mins.

[Andy Velez]

Have you called your clinic to ask them about the kidney pain?