[Question #12968] Self-medicating with HIV treatment drugs and getting tested"
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3 months ago
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"Hello doctor, I need your advice on the following questions: I had vaginal intercourse with a woman, and my penis had a slight abrasion beforehand. Afterward, I developed characteristic HIV symptoms such as: swollen lymph nodes, oral candida, weight loss, rash, prolonged fever, and muscle/joint pain. I used cold medicine and from day 35 after intercourse, I used a corticosteroid prescribed by the pharmacy to treat the rash for about 7 to 10 days. The fever lasted for 15 days, while other symptoms persisted for 70 days, when I began self-treating with HIV antiretroviral therapy (ART) until now (haven't dared to stop). I self-tested using Alere Combo rapid test strips on days 13 and 33 with finger blood and got negative results. After treating myself with ARV medication, I tested negative with Alere Combo rapid test strips on days 90 and 108 using finger blood, and laboratory Ag/Ab tests on days 144 and 255 were also negative. All tests were done while I continued to use the medication regularly.
- I read a Thai study about using ARV during the window period that can cause the body to not produce enough antibodies or delay antibody production. I don't know how long this delay might last for antibody tests to detect infection if I continue taking the medication.
https://www.jci.org/articles/view/150937
- Doctor, is it mandatory that I stop the medication before conducting tests? Is there any way to avoid stopping medication to prevent drug resistance if I am truly infected?"
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H. Hunter Handsfield, MD
3 months ago
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Welcome back. However, it is apparent you did not carefully read Dr. Hook's evaluation in your previous thread, or perhaps misunderstood it. HIV test results overrule both exposure history and symptoms. You describe a low risk sexual exposure; HIV almost never would occur after an exposure like yours, even if your female partner had untreated HIV. And your symptoms, and all symptoms typical of ARS, are far more commonly due to conditions other than HIV. Like many people, for some reason you have come to believe that symptoms are good indicators of new HIV infection or ARS. They are not. Even the most typical symptoms usually have other causes. Even if you had been at high risk, and even if your symptoms had been t typical for a new HIV infection, the test results are what matters. They prove you were not infected and do not have HIV. You should not have treated yourself with HIV drugs, but you tested negative before you took them, and so of course they could not have affected the HIV tests.
The single research study you cite is meaningless in interpreting your situation.
You should not be taking anti HIV drugs and should stop them now. You don't really need addition testing, since it is already certain you do not have HIV. You are free to test again; the results will be negative. You don't need to wait until completing your HIV medications -- but if it would reassure you even further, feel free to test once against 3-4 weeks after the last dose.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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3 months ago
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"Dear doctor, will HIV treatment medications delay antibody development if treatment is started during the 90-day window period?Will antibodies continue to increase if I continue taking medication, or must I stop the medication to get tested?"
My parents have also experienced similar symptoms after having close contact with me, sharing meals, and being exposed to my phlegm and nasal secretions, which makes me very worried. Is there any possibility that my parents could be infected due to high viral load during my early stage (if I am infected)?
I apologize for asking, I am from a poor country, so each time I ask a question represents a significant economic effort for me."
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H. Hunter Handsfield, MD
3 months ago
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It is generally not necessary to stop anti-HIV drugs in order to have reliable results. A reasonable approach would be to test while still taking the drugs, then test again a few weeks after the last dose. You can be sure both tests will be negative.
You are interpreting your parents symptoms is exactly the opposite way than the truth. That your parents or others around you experience the same symptoms is solid evidence that your symptoms are NOT due to HIV. The virus is NEVER transmitted to household members who are not sex partners of the infected person.
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3 months ago
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Does that mean I still need a confirmation test after stopping the medication, doctor?
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H. Hunter Handsfield, MD
3 months ago
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There is no need since you were at little or no risk and therefore there is no possibility you have HIV. On the other hand, when someone has taken appropriate post exposure prophylaxis, the standard advice recommended by most experts is to test again a few weeks after the last dose of drug. Probably there is no true need, but this is what is recommended by most experts. So it's up to you.
That completes two follow-up questions and replies and so ends this thread. Please note the forum policy against repeated questions on the same topic. This being your second, it should not be necessary to ask again about the same issues. Such repeated questions may receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and is intended to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thank you for your understanding.