Is It Safe To Switch From PEP To Zidovudine Post Possible HIV Exposure?
I am on my 5th day into pep 3 combination but the side effects has been so severe that I was almost stopping the pep, but i held on, hence I want to change to Zidovuden. Can someone please answer me here?
PEP has to be competed for 4 weeks
Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
When that girl is HIV positive, the risk of HIV transmission can not be ruled out without a test on appropriate time. Thrusting four times is not the mater. Just a contact also has risk. At the same time all the contacts were not necessarily infectious always. The test done to you is not reliable as you are in window period. PEP also would be effective when it is started as early as possible. Side effects of the drugs and intolerability may likely to become lesser after few days.
So try not to stop the present regimen. If not possible change the drugs with the guidance of your physician. He/she may alleviate the side effects by adding some supporting drugs. So complete the PEP. You will be free from HIV.
Dr. S.Murugan
Zidovudine with another two drugs tried for PEP
Detailed Answer:
Hi,
Welcome back.
All exposures were not necessarily infectious. Spouses of HIV positives remain HIV non-reactive in spite of their regular sex contact for years together and they are called as Discordant couples. So there is likely chance for you to remain HIV free.
You had not mentioned what exactly your three drug combination contained. It would usually include Truvada combination. Depending upon the third drug (Effavirenz or Lopinavir) your symptoms have to be managed.
Zidovudine alone is not recommended for Pep. 3 drug combination is said to be more effective. Zidovudine along with other two drugs can be tried as PEP.
Dr S Murugan
uninterrupted PEPwould be more effective
Detailed Answer:
Hi
Welcome back
Previously there were two types of regimen were for PEP. Basal regimen (2 drugs), extended regimen (3 drugs). Now PEP has only three drugs regimen only
Side effects of Effavirenz or Lopinavir may be severe only for few and not for all.
Pep would be effective only when taken uninterruptedly.
Dr S Murugan
continue and complete Truvada alone for 28 days
Detailed Answer:
Hi,
Welcome back
Truvada plus Lopinavir (2 tablets twice daily) is the ideal combination. If you are not able to get Lopinavir tablets, continue Truvada alone once daily as.per the old regimen. Dr S Murugan
HIV risk is almost nil if the compliance is 100%
Detailed Answer:
Hi,
Welcome back
If you had started PEP within 12 hours after the risk activity, your riskfor HIV is almost nil if you complete the course of PEP.
Dr S Murugan
Not 100% safe, a negligible risk is there.
Detailed Answer:
Hi,
Welcome once again.
PEP can be started within 72 hours. After which it has no value as the disease got established in the presence of an infection.
If you had started PEP by 40 hours, I would not say you are 100% safe . But when you complete the PEP, I would say your risk is low and you protection is around around 90-95%. It means that you are having a negligible risk.
Dr S.Murugan
unlike mathematics, in Medicine things can not be predicted exactly.
Detailed Answer:
Hi,
Medicine is not mathematics to have constant answers or fixed answers. When started a little late than 12-24 hours the PEP safety may likely to vary slightly and 100% safety can not be assured. That being said, we consider the risks of infection after complete PEP treatment as very negligible.
Dr S.Murugan
nothing to worry. you would be safe with PEP
Detailed Answer:
Hi
Welcome back
There is nothing to get panic.
The odd is less than 0.5 % slip with PEP.
Not to worry.
Dr S Murugan