[Question #8284] Follow up to q8240

46 months ago

Dear doc ,

Hope you are doing well.

This is regarding a follow up to question 8240.

Just to brief , I am a gay male and I masturbated with a friend of mine , his semen came on my face and I think a drop might have got into my eye .

I panicked and a doctor put me on PEP. I started pep at the 21st hour after the exposure .

My friend tested the next day from a hospital and sent me his reports . The results were non reactive .

However since yesterday about 16 days after the exposure I have got a terrible stuffy nose and cold . I felt a sore throat and now it’s become a cough with congestion and sputum . I also had 99 to 99.5 fever at times , going upto 100. I took a paracetamol and the fever dropped to normal .

I am worried If these could be hiv symtoms ? Please advise , thanks .

Edward W. Hook M.D.

46 months ago

Welcome back to the Forum although I’m sorry you felt the need. As we have previously discussed the exposure you described was virtually no risk. In the interval since then you have learned that your partner had a -4th generation combination HIV antigen/antibody test following your encounter. Persons who have -4th generation tests cannot transmit HIV. Further, recently acquired HIV does not cause congestion. Your symptoms are far more consistent with an every day upper respiratory tract infection.

There is no reason for continued concern regarding the encounter you described. Based on the results you have just provided, there is also no reason for further testing. You are at no risk for acquisition of HIV. Please don’t worry. EWH

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46 months ago

Thanks a lot dr Hook for your quick response .

The test done by my friend was Vitros ECI , based on the principle of enhanced chemiluminescence immunoassay.

I don’t know if it was a third or fourth generation test .

It was done at a reputed hospital in India .

Also just wanted to check, from your experience have you seen any cases where semen in the eye has caused hiv ?

I have read about several cases where blood splash in the eye caused medical professionals to be infected but not sure about semen .

Finally , since I’m an overly anxious person , I plan to start with prep , wanted to understand the regimen for prep on demand .

Thanks again

Edward W. Hook M.D.

46 months ago

You continue to worry entirely too much. The case reports of persons becoming infected through splashes into the eye occurred in the settings of laboratories where people were working with very high concentrations of HIV for a laboratory experiments. I know of no instances in which a person has become infected with HIV through the splashing of ejaculate into their eye. none/zero/not one.

PtEP on demand appears to work well. For PrEP on demand, persons take medications such as Truvada on a 2-1-1 schedule in which the first dose of two Truvada tablets is taken 2-24 hours before sex, then one tablet is taken 24 hours later and then the final Truvada tablet is taken 24 hours later. I suggest that if this is your plan, you discuss it with your regular doctor.

EWH

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