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Post exposure prophylaxis of HIV - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: HIV and AIDS
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3602 Questions
User :   Hi Doc, my cousin had unsafe anal sex with an HIV positive man. This was on night of 31st OCT. we then did his western blot test, ELISA and DNA PCR. The blood sample were taken on 6th XXXXXXXX and all his results have indicated negative presence of HIV. He was none the less prescribed VIRADAY for 45 days. Please let me know the sanctity of the results....
Doctor :   Hi
User :   hi doc
Doctor :   I shall help you in this.
Doctor :  
May i know the age of your cousin?
User :   he is 21 yrs
Doctor :  
Ok
User :   As you can understand this has been very traumatic on him and me as he confides to me only
Doctor :  
The test done except for DNA PCR looks at finding the antibodies to HIV.
Doctor :  
And commonly these antibodies are present after 3 to 4 weeks after exposure.
Doctor :  
In some people these antibodies may take atleast 3 to 6 monts for it to appear.
User :   yes i am aware of that as i understand the first two rely on sero conversion post infection... i am worried about the dna pcr
Doctor :   Ok.
Doctor :  
DNA PCR is the most sensitive test.
User :   was it too early or is 6 days a good incubation period to get conclusive results
Doctor :  
IT gives us true reults in about 95% of cases.
Doctor :  
But there is always the doubt unless you repeat the test after 3 weeks or 3 months,
User :   ok so what do you suggest we should do ... should we wait or go through the whole regime again as its 16th tomorrow and it will be 16 days from the date of exposure
Doctor :  
Hence i cannot guarantee that these tests are exact.
User :   ok
Doctor :  
Since he has a=has exposure to a confirmed case.
Doctor :  
I suggest him to take post exposue treatment.
User :   ok
Doctor :   There are a group of drugs that are used following exposure.
Doctor :  
I cannot prescribe those online.
User :   but he said that 15 mins after exposure he went and craped and that the guy did not ooze too much of semen, is the risk still high
User :   ok
User :   i understand ... we are refering to
Doctor :  
If there was no fluid contact and he had washed
Doctor :  
following the contact
Doctor :  
the chances of infection is less.
Doctor :  
But i shall not suggest him to take that risk.
Doctor :  
Yes
User :   yes thts true he us a fool
Doctor :  
And he shall help him with the needfull.
Doctor :  
I would suggest him to take the post exposure treatment soon.
Doctor :  
Is there any other query that i can assist you with?
User :   yes he is taking Viraday as I had told you earlier one tab XXXXXXXXry day..and thanks let me jus ask him if he wants to ask u anything else
Doctor :   Please.
User :   pls be patient with me as I am chating with him over phone at the same time
Doctor :  
Thats ok.
User :   So you know Dr. AAAAAAA .. you know how we patients are always looking out for second opinion ...but when I read about DNA PCR test on the web it said that we need at least 7 days before the test needs to be conducted so is the result after 6 days a good representation
Doctor :   I do not know about .
Doctor :  
But i do know that he is the expert.
Doctor :  
As i said earlier DNA PCR looks at the hiv DNA in the blood
User :   ok ... One more thing... My cousin is having a regular dizziness, some nausea and falutance is this due to medicine VIRADAY
Doctor :  
Small traces of DNA found can be ppicked up by the test
User :   Oh great to hear that
User :   ok
Doctor :  
Hence it is the most sensitive of all the tests.
Doctor :  
If the test comes negative
User :   ok
Doctor :  
Thee chances of him being positive is low.
Doctor :  
But XXXXXXXXry test cannot be relied.
User :   ok
Doctor :  
it has to depend on the clinical history and examination.
User :   and his current symptoms are these due to the Viraday
User :   ok
Doctor :  
And as your cousin has had history of exposure,
Doctor :  
let him take the medications.
Doctor :  
Recheck those test as needed.
Doctor :  
I am sorry .
Doctor :  
You did not mention any symptoms to me.
User :   yes I did I'll just retupe
User :   My cousin is having a regular dizziness, some nausea and falutance is this due to medicine VIRADAY
Doctor :   yes these are the side effects of the viraday medications.
Doctor :  
If these symptoms are troubling him
Doctor :  
he cantake medicines to counter these.
User :   ok great and he also feels a lot hungrier these days
User :   is that some kind of increased metabolism due to the medicine
Doctor :   increase appetite is not the effect of these drugs.
Doctor :  
Metabolism is definitely increased.
User :   ok but since he has started medication he been eating lot more than usual and feels lot hungry
Doctor :  
But it is not know to increase the appetite.
User :   ok
Doctor :   That is not a problem.

User :   yes :-) was jus making sure he is safe
User :   thanks doc
Doctor :   Also give j=him moral support.
Doctor :  
He should not suffer from depression
Doctor :  
because of these.
User :   IS there any thing else you would like to suggest ... yes definitely
User :   I know he keeps saying that he'll kill himself I have been distracting him by all means
Doctor :   Give him education about HIV
User :   yes i will
Doctor :  
And if he has any problem either medically or pschologically, he can chat with us.
Doctor :  
Here the doctors will know better how to handle him.
User :   sure i will tell him thanks doc good bye
Doctor :  
Continue the support you guys are giving him.
Doctor :  
Thanks for consulting HealthcareMagic. Bye for now. Please refer your friends to our service.
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