A Man Who Beat HIV for 30 Years | Hacker News Reader

A Man Who Beat HIV for 30 Years

nautil.us

48 pointsBIackSwan19 comments

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.

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.

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.

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

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

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.

(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.)

> 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.

I just thought I'd say, advanced in treating HIV have progressed immensely. And for people who test positive, if it's early enough, HIV no longer has to be the kind of withering death sentence it once was.

It's certainly no fun, but the prognosis is vastly improved.

https://www.aidsmap.com/Life-on-HIV-treatment-a-personal-per...

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.

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.

I would say that's a minority of viruses. There are some great examples of viruses that stay dormant in the body (HSV, HCV), but most viruses are completely cleared by the immune system.

I thought that too, and read this looking for a good resource on it:

http://www.ncbi.nlm.nih.gov/books/NBK8538/

Several times it discusses viruses that are treated as acute but probably persistent (including measles and various intestinal and respiratory viruses).

The immune response is plenty strong as it is. The problem is getting it to target things that have evolved for thousands of years to avoid it.

Auto immune diseases and allergies are some indication that it is a delicate balancing act.

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.

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

Could you link to the CDC claim that 30% of the US population shows signs of exposure to spinal meningitis? I'm unable to find any references. Personally, I find this quite probable, since antibiotics are already known to reliev some back pain.

Whooping cough is caused by bacteria (Bordatella pertussis). It is virtually unheard of for whooping cough to re-activate, catching it again as a new infection is much more likely.

Incidentally, there is a zoster vaccine that can prevent shingles[1]. If you have ever seen anyone with the debillitating pain that shingles can cause, you will realise that this vaccine is definitely worth it.

[1] http://www.cdc.gov/vaccines/vpd-vac/shingles/vacc-need-know....

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.

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?

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