
A Man Who Beat HIV for 30 Years - BIackSwan
http://nautil.us/issue/23/dominoes/the-man-who-beat-hiv-at-its-own-game-for-30-years
======
spoiler
This is kind of a touchy subject for me. I don't practice unsafe sex but I had
unprotected sex once with a guy I was dating who got pretty close to
contracting the virus a day before we had sex. He is a medic and he was
measuring a woman's blood sugar after she fainted. It was a small office where
it happened and as he was taking the stabby pen someone pushed him and he
accidentally stabbed his palm (he's unsure how the pen was armed). He didn't
think much of it and took some mandatory tests, but after a few weeks he found
out the woman had HIV.

We both got tested (he got tested more extensively and a few times because of
his work), and we were both negative, thankfully.

To make things worse in the early phase of the virus most people develop a
fever and have flu-like symptoms (according to WebMD, lol). It was just around
flu season; I contracted the flu. Those two weeks that it took the test
results to come back were probably the worst of my life. I can't even describe
my state of mind. I was _mortified_. Also, the stress made my depression worse
and I was genuinely on the verge of committing suicide at least a couple of
times. I think the only reason why I didn't commit suicide at the time was
because I thought it would effect him (the guy I was dating) too much.

After I found out I wasn't HIV positive, it took me about 2 weeks to recover
from it. I tested for HIV a few more times after that, even though I didn't
practice sex at all since then.

I'll never underestimate the wisdom behind the simple phrase that is _play
safe_.

On the subject of unwanted intrusion: What's with all the spammy comments on
that post? I always considered Disqus to have pretty good spam protection.

~~~
Grazester
Did he have Pep treatment after this exposure? I would be surprised if as a
medical worker who was exposed to the virus he didn't. You really can't trust
the internet to tell you if you have HIV based on symptoms.Everything begins
to look like a symptom when you are worried about any kind of sickness or
ailment and it just happens at those glorious times too.

~~~
spoiler
Yeah, he got PEP'd right after he was exposed to the woman's blood as a
precaution. I'm not sure if that covers HIV; he was equally stressed about the
whole thing as I was.

He found out the woman has HIV from a colleague, but only ~10 days after being
exposed.

~~~
Grazester
PEP is solely for HIV.
[http://www.cdc.gov/hiv/basics/pep.html](http://www.cdc.gov/hiv/basics/pep.html)
Yeah I could imagine how stressful that situation was.

~~~
cblock811
I've only heard it called PrEP, not PEP. PRe-Exposure Prophylaxis. Curious if
there are other communities who call it PEP though.

~~~
spoiler
PrEP stands for Pre-Exposure Prophylaxis, PEP is Post-Exposure Prophylaxis.

Basically you need to start PEP treatment within 2 hours for it to be
effective.

Also, it appears he didn't start PEP treatment[1], they probably didn't deem
it necessary at the time; PEP itself can have some serious side effects.

[1]: I read in the article linked by @Grazester that you need to take PEP for
about a month, and I wasn't aware of him drinking any special medications
during that time.

~~~
throwaway81328
(I'm a frequent HN user posting under a throwaway account for obvious
reasons.)

I was exposed to HIV last year - a guy who didn't use a condom even though I
told him to, and who a friend later told me was very probably HIV+. I got on
PEP, but not in 2 hours, but within about 12 hours. The earlier the better,
but doctors suggest that up to 72 hours is fine.

The medication given differs based on country - basically, the same set of
drugs used for HIV are used, but different health systems will rotate through
different drug sets.

I was on Truvada (emtricitabine and tenofovir disoproxil fumarate), which is
also used for PrEP. One pill a day for 28 days. I was also on Kaletra
(lopinavir/ritonavir), two pills twice a day. The doctors also gave me a whole
load of generic anti-diarrhea pills because that's a common side effect of the
Kaletra. They also told me that they were going to soon be changing the
protocol for PEP and substituting a different drug for the Kaletra,
specifically to ease the side effects.

The side effects for me were pretty bad: lots of tiredness, some nausea,
diarrhea, vomiting and other gastro-intestinal issues. I was also trying hard
to deal with the pretty ghastly feeling of being sexually assaulted. Two weeks
in, they also did a test to make sure the drugs weren't causing me any liver
problems, as that's a known but very rare side effect.

I'm glad that it is available: every hospital in Britain is set up to hand out
PEP in emergency departments, and you are handled quickly. There's also a
standard 'checklist' test that doctors use to decide in the case of both
sexual and occupational exposure whether to prescribe PEP.

And as you said in your post, I had flu and cold like symptoms (because, duh,
it was winter) and I misinterpreted them as seroconversion symptoms.

In my case: I've had regular blood tests for HIV every three months since
exposure according to schedule. All negative so far. :)

(And the police can take no action against the guy, because the laws in this
country are shit and ignoring someone's safe sex preferences isn't a criminal
offence. And everyone scoffs when feminists talk about 'rape culture'. The
assault/trust issue side of it has given me panic attacks but I'm coping a lot
better than a lot of people.)

~~~
monksy
> And everyone scoffs when feminists talk about 'rape culture'.

Thats not a gender/rights related thing. Thats an assault on someone. The guy
was pretty shitty, and that could [assuming he knew about it and intended it]
be considered an assault. To call it a rape would be wrong.

------
lkrubner
When my dad was 9 years old he had whooping cough. Then it went it away for 55
years. Then, slowly, it began to creep back, as he got older and his immune
system became less aggressive. And I think this is a common story for almost
any virus: once you get it, you have it for life, but for most of your life,
while your immune system is strong, the virus will remain repressed. But once
you get older, those viruses start coming back.

We know of many viruses that can resurface, decades later. Shingles is perhaps
the most common, something like 25% to 33% of people eventually get shingles
(according to the CDC, 96% percent of the USA population has the herpes zoster
virus).

And of course, we now know that many things that used to be thought of as a
natural part of the aging process are in fact caused by bacteria:

gum disease

stomach ulcers

heart disease

There is also evidence that most back pain is caused by bacteria (according to
the CDC, 30% of the USA population shows signs of exposure to spinal
meningitis).

There is also the theory that certain forms of dementia are driven by
bacteria. (Dementia onset following a bout of pneumonia is a common story.)

I think this man's story fits into the ordinary story of a man getting older
and his immune system getting less aggressive.

In terms of cost/benefit analysis, it is worth noting, if we could find a
general way to boost the immune system, the benefits would apply to thousands
of illnesses, including all of the most common ones. Research on any one
disease is less likely to yield the sort of wide benefits that boosting the
immune system would offer. Such research (to boost the immune system in a
general way) might seem a bit far fetched, but I think it justified by the
large benefits it could yield.

~~~
cperciva
_if we could find a general way to boost the immune system_

We have ways of boosting the immune system. Unfortunately they tend to result
in patients dying of multiple organ failure when the overactive immune system
attacks cells which we can't do without. Even when dealing with infectious
diseases, many deaths are caused not by pathogens but rather by the immune
responses to them.

What we need is a way to _selectively_ boost the immune system.

~~~
rsync
Actually, we have a way to boost the immune system that has none of those side
effects - regular, moderate exercise.

------
adevine
The section of this article that discussed a "potential downside" of anti-
retroviral treatments being that they prevent human evolution seemed downright
offensive to me. I don't think the author realizes it but what he is
suggesting is basically eugenics.

Evolution against pathogens works by killing off most everyone who isn't
naturally immune. The fact that we can halt this process with drugs and
technology isn't a "potential downside" \- it's the goal.

~~~
evincarofautumn
The problem that the author describes is that we can’t discover who’s
naturally immune and thereby develop cures if we always halt the natural
immune process with treatments. I don’t know how scientifically valid this is,
but it seems at least a valid ethical concern: if we could eradicate a deadly
disease by sacrificing a few people, should we?

