PEP TREATMENT PROGRAM

 One Of One of The Most Comprehensive HIV Testing Center for Early Evaluation

  Confidential, Accurate, Certified and  FDA approved results today  

 72 H Chance to remain HIV Negative

TEL: 323-231-6000 

 




















1-888-DR-ARANI

 

 

 

   YOU HAVE ONLY 72 HOURS AFTER EXPOSURE TO HIV TO DECREASE YOUR CHANCE OF BECOMING POSITIVE    

      

Call 323-231-6000 for HIV prophylactic treatment consultation ( No walk in is accepted)

 

PEP:

It stands for Post Exposure Prophylaxis. It means If you get exposed to HIV virus there is a short window period of 72 hours that under supervision of an experience doctor you could take special anti viral medicine. In this way your HIV infection might not get finalized and you increase your chance that you remain HIV negative !

The most effective methods for preventing human immunodeficiency virus (HIV) infection are those that protect against exposure to HIV. Antiretroviral therapy cannot replace behaviors that help avoid HIV exposure (e.g., sexual abstinence, sex only in a mutually monogamous relationship with a non infected partner, consistent and correct condom use, abstinence from injection-drug use, and consistent use of sterile equipment by those unable to cease injection-drug use). Medical treatment after sexual, injection-drug--use, or other non occupational HIV exposure* is less effective than preventing HIV infection by avoiding exposure.

 

How effective is this method:

There is no randomized, placebo-controlled clinical trial to check the true effectiveness of the treatment, and probably will never be a clinical trial because it is unethical to put people life at risk of HIV infection in order to test a drug. However, it seems to be effective . This approach is recommended by CDC and you could get more information on that from cdc.gov.

There are some data available from animal study and health care workers who got exposed with infected blood or HIV positive pregnant mothers who got similar approach which might sometimes reduce the risk for HIV infection after exposures by getting PEP.

 

Qualification: Not everyone would be qualified for the treatment. We evaluate the situation case by case. For example: if you have unprotected intercourse with HIV positive person then you will be a strong candidate.

 

How much does it cost: PEP management is slightly different from person to person. Anti- HIV PEP medicine, diagnostics and follow up for one month have cost involve, but if you become HIV positive then you need all of those for life which is much more expensive than one month. We have done some arrangment with speciality HIV Rx Pharmacy to give discounted medicine to our PEP patients, however you have option to go to any pharmacy you like to get your PEP medicine.

In conclusion, it will be the cheapest investment of your life for 30 days if it works and change your destiny. However, not everyone is candidate regardless of affordablility. We evaluate and inform you if you are andidate when you come for initial PEP consultation.

 

72 Hours: You have only 72 hours after exposure to HIV to take PEP. The sooner the better. You should not wait for last minute. You have to consider many elements such as, the time you need to spend in the clinic in order to get evaluated, the time you need to spend in pharmacy in order to fill your prescription. Pharmacy dispensing time and the most important of all unexpected obstacle such as getting flat tire, trafic on the way you come to the clinic, missing appointment or just simply cancellation of your appointment by act of God or other reason by us.

If you start on early hours then you always have time for PLAN B.

We do not guarantee or take no responsibility if you are late for your PEP treatment for any reason or if you acted on clinic non operation hours, unavailability of appointment financial cost of PEP management such as paying for your prescription . This is not the time in your life for procrastinating.

 

 

Real Case Report:

I will give you 2 examples.

I tried it myself:

When I was doing my residency in MMC hospital in Phoenix Arizona, the big splash of blood scatered on my face while my intern was placing Swan-Gans cath in patient's chest. I was devstated and very afraid of getting HIV. At that time I was notified by hospital of post exposoure prophylaxis (PEP) . I was given PEP medicine and fortunately I remained HIV negative by subsequent testing by my teaching hospital.

I gave it to my patient:

We received the phone call from a doctor who had sexual contact with a new partner which he met at a bar. After the sexual contact he noticed that his genitalia is contaminated with the girl's blood as she was menstruating. He became anxious and started questioning her just to find out that she was HIV positive. We initiated post exposure prophylactic treatment as last hope to protect him against HIV infection. He took PEP treatment recommended by us for one month and follow up for 6 months as he was finally declared as HIV negative. We could never find out what would be his HIV status if he had not taken PEP treatment, but that was the only option he had. One of the most important aspect of this example is that he was a doctor himself. HIV does not care about your status if you are poor, rich, prisoner or president. HIV is life changing syndrome it will impact your health, your financial status, your relationship and many other aspect of your life so use protection and get tested routinely and do not put yourself and public at danger.


 

Risk:

Blood transfusion > Needle Sharing injection Drug Use> Receptive Anal Intercourse > Precautions Needle stick > Receptive Penile Vaginal Intercourse > Insertive Anal intercourse > Incertive Penile-Vaginal Intercourse > Receptive Oral > Incertive Oral

 

 

 

 

 

HIV Testing:

Because persons who are infected with HIV might not be aware they are infected, baseline HIV testing should be performed on all persons seeking evaluation for potential HIV exposure. If possible, this should be done with an FDA-approved rapid test kit (we can do it in 15 minutes). If you are already HIV positive then you were not aware of it then maybe you do not need PEP and you need to be seen and follow up for your HIV treatment.

 

Follow ups:

If patient is candidate for Post exposure prophylaxis then candidate should have follow up evaluation and testing based on CDC recommendation. HIV medicine has risk and side effects and we need to check your liver, kidney and blood test to make sure the medicine is not effecting your health.

Our complete PEP management program will cover all these area till you get final test in 6 months to confirm your treatment has been successful and you are HIV negative.

 

 

Early stages of HIV infection may associated with some symptom. Following table will explain to you what symptom are the most common symptoms, but you should know that you won't have any symptom at beginning or no symptom at all to begin with.

 

Example of Stages of HIV

Viral Transmission (2-3weeks)--->early  retroviral syndrome(2-3 weeks)----->Recovery & seroconversion-------> No symptom HIV infection ( average about 8 years)-------> AIDS (avg 1-2 years)-----> Death

 

Possible Early HIV infection Symptom (retroviral syndrome)

Fever , Headache , Tiredness, Enlarged Lymph nodes

 

Possible Later HIV symptom(before AIDS)

  • Lack of energy
  • Weight loss
  • Frequent fevers and sweats
  • Persistent or frequent yeast infections (oral or vaginal)
  • Persistent skin rashes or flaky skin
  • Pelvic inflammatory disease in women that does not respond to treatment
  • Short-term memory loss

 

Window Period & Test Timing:

There are many tests available to detect HIV (EIA, Immunoassay, western blot, DNA PCR, Antigen testing, RNA PCR, quantitative viral load etc). The standard HIV test is a HIV antibody test. It will give you your HIV status (must always consider window period and future testing). It takes time for our body to produce antibodies against a HIV infection, so in the early acute phase of infection patients could be infected but the antibody test could come back negative. You must always test again in 6 months to confirm your result. 

 

Why is it important that our lab has permission to test for HIV?

It is a California law intended to protect the safety of patients. HIV testing needs its own exclusive permission from the state. Doctor office in California must

go under proficiency testing even though the test might be cliawaived. We are routinely evaluated by a third party in order to guarantee that our lab is accurate. This means that on a routine basis we receive unknown samples and we run HIV tests on them in order to evaluate our test results. We constantly undergo internal quality control as well, so you could feel confident about the reliability of your test result. 

 

 

 

We Can Offer

POOL Sampling Test to detect HIV in just days after exposure (NOT A DNA PCR which can only be done after 1 month)

Because an acute infection, prior to sero-conversion, is usually accompanied by high viral titers (10E5-10E7), it is possible to identify viral NA with sufficient sensitivity in pools of >100 samples per test. The sensitivity of tests per individual sample included in the pool is approximately 2000 copies/ml. However, pooled sample testing has been optimized to detect an impressive low number of 1-5 copies per milliliter of HIV RNA (HIV does not have DNA, it has RNA) in a 512 specimen pool (blood sample). This test has been approved for the screening of plasma products. This is difficult and time consuming especially when a pool becomes positive, but it is an ultimate way of testing.In recent studies, the interval of nucleic acid detection to first antibody reactivity ranged from 6-42 days with a median interval of 11.5 days.

 

 

Many unlawful testing websites promote this test as early as 48 hours after exposure which is incorrect: "Nucleic acid tests for HIV DNA, but they are not approved by the FDA for diagnostic purposes" If you are negative with HIV DNA PCR it is not going to be your final result. This test is not to be done until 30 days after exposure. It is the test to be use only in certain circumstances

 

Misleading Online Testing

One web site with hundreds of of "Testing Centers!"

These internet "HIV Testing Center" web sites are mostly located outside of California, and most of them are just a web site without a physical location. They charge the buyer and send the patients to a lab specimen receiving center without an actual doctor visit or situation specific testing and interpretation of results. They claim they have more than 1800 and sometimes 2500 STD/HIV testing centers/clinics nationwide! This is misleading. These centers are often nothing more than a toll free number, credit card machine and "HIV/ STD test" sales person. For PEP treatment you have only and only 72 hours to get treated to remain possibly negative and if you delayed by waiting for few days of test result then you will loose that window of opportunity.

 

We are capable of checking for both HIV 1 and HIV 2 with blood or oral fluid in a few minutes. Our test is highly accurate, FDA approved, and done in our certified lab. We do not do home test or non-FDA approved self tests. An experienced medical doctor and not just a counselor will talk to you and answer all your specific questions. We will provide you with the official report with both the MD and Lab Director's signature the same day for your record, your doctor, or your partner. If you can not wait hours or days for your HIV test result,  then we can provide one to you in minutes. We are centrally located in Southern California. 

When it comes to HIV testing, count on us.

                                                           

 

 

What is HIV RNA? It is a nucleic acid inside the HIV virus which contains genetic information.   

 

What is Human DNA? It is a nucleic acid inside human cells which contains genetic information.  

 

What is HIV 2 ?

There are 2 type of HIV today so just checking for HIV (1) does not mean you are positive or negative for HIV (2) as well. Find out more about HIV-2 on the following web site:

http://www.cdc.gov/hiv/pubs/facts/hiv2.htm 

 

Travelers to the Ivory Coast, Gambia, Nigeria, and Sierra Leone - if have been exposed to HIV, you may get a false negative test result in the USA as most of the HIV tests only offer HIV 1, which may not detect HIV 2 unless you inform your doctor and request a HIV-2 test as well.

 
HIV self run tests!: All of these are Non-FDA approved, and their distribution in the United States is prohibited and illegal - you may contact the CDC or FDA in order to confirm this. Be aware of misleading professional looking web sites. No matter what sales venders may claim regarding accuracy and being "FDA approved," this is not true. They are not tested and approved by the FDA and not clear for sale in the United States - many are bogus with unreliable false positive or negative results. You may contact the FDA to verify for yourself that there is no approved self-run HIV home test. To this day there is no approved home run HIV test clear and approved in the USA and that is why you cannot buy them in your chain or local pharmacy. See the following FDA links:

http://www.fda.gov/oashi/aids/testwarn.html

http://www.fda.gov/fdac/departs/1999/499_irs.html

 

Home HIV Test/Self Kit:  AIDS by HIV is a terminal illness. Imagine placing an accuracy burden on a simple home test - do not try to run this test by yourself! Dr. Arani is strongly against these tests ("HIV is not a home cholesterol test, results will impact ones life immediately"). Some of these tests state that they should not get wet, some say to look at one line/dot for negative and 2 for positive. How sure you will be about the result? Is it approved? Did you test exactly the way they instructed because if you didn't get a accurate result then no one will take responsibility. For instance, instead of 3 drops of blood you had 2 1/2 or some blood sample stays on a corner of the test kit, now what? Are you still sure about the results?  HIV testing should be performed by an experienced and responsible health professional and finalized by a certified medical laboratory. In this way, you will walk out with a fair confidence in your test result.

 
According to the FDA-"Donít be fooled by a professional-looking web site. Anyone can hire a web-page designer to create an appealing site."
Unfortunately, there are many unlawful Internet web sites that function as a HIV/ medical/ STD test sales vendor. They get patients credit card info and send orders to a lab center like a menu!  Labs may assume that the patient was seen physically by a real doctor and would therefore be screened by the appropriate test. We have seen many patients with inaccurate and wrong testing. In this way, these web sites put the public and both sexual partners at risk because of misleading HIV test results.   
 
What is recommended?:  The Center of Disease Control does not recommend HIV DNA PCR for HIV testing (we have contacted the CDC on 1/31/2006 to confirm this). It is very important that the method for choosing the type of testing is done by an experienced physician after receiving your history and evaluating your risk factors at the time of exposure and after preliminary results.
 
How do we do it ?
When you come to our center we will provide you with testing options and an explanation sheet. Then the doctor (MD) will answer all of your questions and discuss your testing options - consent will be obtained and test will be run. Doctor will give you your test result and speak with you about the result. You walk out with your official test report in few minutes.
 
What is 100% sensitive (fda-approved)test means ?  It means that test will detect the HIV-1  in all (100%) of  people who have HIV antibody. So if you are negative with our test you should have a well confident on your negative result after window. In other word,  Lower sensitive test may give you false negative result.  
............................................................................................................
Who could get tested for antibody ?
Whoever would like to know his baseline HIV status, it will give your HIV status after window period been met.
 
Who could get tested for special antigen ?
This test may be ordered if you have been recently exposed to HIV and you are really anxious and  want to get possible more information regarding your HIV status before you develop antibody for routine Approved HIV antibody testing. This test is not routine test and will performed considering your exact possible timing of HIV exposure.  
 
What does this result mean? A positive result means that you are infected with HIV.
 
 

What is HIV Antigen (Ag)? They are part of structure of  HIV (virus). The test will detect  these particle directly 

 

What is HIV Antibody (Ab)? It is what our body makes (special protein) against HIV (Ag) to fight against it. It takes some time that body produce antibody. The test will detect for antibody that our body produce. So indirectly we detect HIV , in other word, if you have antibody against HIV then you have the HIV 

 

 

see structure of the virus in following HIV picture membrane and glycoprotein

 

Compare different method of HIV tests

 

Testing Met od ...How it checks.....When to Check

HIV antibody test

(FDA recommended)

check for

antibody against HIV

                    

we use immunoassay, rapid antibody detection

 

our lab HIV

test check for antibody against HIV                 

HIV Western Blot

for confirmation

if antibody test became positive

Gold standard when HIV antibody is positive

when HIV antibody test become positive WB will confirm the diagnosis of HIV 

HIV antigen Test

check for presence of small molecule protein which exist in core  

FDA has recommended that all

blood and

plasma donations be screened with tests for HIV-1 using this method because these test results frequently become positive before assays for HIV antibodies, not recommend for routine diagnostic testing

Valuable in detecting HIV infection early in the window period after exposure within three weeks after exposure

PCR-DNA

(qualitative PCR)

check for DNA

in cells of infected

   

not recommended for first 28 days after exposure for increase false negative  Not approved by FDA for diagnostic purpose

Viral detection in case of neonatal HIV & indeterminate serologic tests ..only after 28 days of exposure

Viral Load test

(quantitative PCR) 

 

 

 

 

 

Amount of HIV in blood stream

mostly for known HIV/ AIDS patient

some infected individual may have no viral load early in disease

will reveal how much virus is in a person's bloodstream (the viral load).

Pool sampling testing of Ribonucleic acid               

HIV presence in pool sample of blood            

 

could detect

HIV as early as possible                   

 HIV virus in blood sample                              

Above information and table is just for basic understanding and for our patient use only may not have diagnostic or therapeutic value. This must get explain by experienced physician for you.

 

 

We perform variety of different HIV tests in our center

 

When you walk in to our center you will be seen by Dr. Arani

All your questions regarding HIV testing/ risk/ transmission will be answered. Pre test counseling will be done. Your risk will be evaluated  and we will perform confidential HIV test for you. Doctor will give your test result and official test report will be provided to you on same day since we have our own lab. 

 

 

 

 

 

 

                                              

       

         

HIV in Oral Sex: According to recent study and CDC

"Yes, it is possible for either partner to become infected with HIV through performing or receiving oral sex. There have been a few cases of HIV transmission from performing oral sex on a person infected with HIV. While no one knows exactly what the degree of risk is, evidence suggests that the risk is less than that of unprotected anal or vaginal sex.

If the person performing oral sex has HIV, blood from their mouth may enter the body of the person receiving oral sex through

  • the lining of the urethra (the opening at the tip of the penis);
  • the lining of the vagina or cervix;
  • the lining of the anus; or
  • directly into the body through small cuts or open sores.

If the person receiving oral sex has HIV, their blood, semen (cum), pre-seminal fluid (pre-cum), or vaginal fluid may contain the virus. Cells lining the mouth of the person performing oral sex may allow HIV to enter their body.

The risk of HIV transmission increases

  • if the person performing oral sex has cuts or sores around or in their mouth or throat;
  • if the person receiving oral sex ejaculates in the mouth of the person performing oral sex; or
  • if the person receiving oral sex has another sexually transmitted disease (STD).

Not having (abstaining from) sex is the most effective way to avoid HIV."

 

"likelihood of transmission of HIV from an infected person to an uninfected person varies significantly depending on the type of exposure or contact involved. The risk of becoming infected with HIV through unprotected (without a condom) oral sex is lower than that of unprotected anal or vaginal sex. However, even a lower risk activity can become an important way people get infected if it is done often enough".

"Nearly half (3 of 8) of these cases reported oral problems, including occasional bleeding gums. Almost all (7 of 8) of these men reported to have had oral contact with pre-semen or semen."

                               

Gum Disease, Lip sore, Dental problem aphthous ulcer & Oral sex

All of the above oral pathology could increase the possibility of exposure to sexually transmitted disease. If you have fissure on your lip, if you have mouth sore, if you have bleeding gum if you have had recent tooth extraction by performing oral sex you are at both risk of getting or giving STDs to or from a partner. For you to understand this concept I would say HIV-1 to be 110 to 128 and 132 to 146 nm , so it is about 0.00011 to 0.000014 millimeter. It is so small that you can not even imagine it. It is hardly be seen by electron microscopy. In this way by having slightly bleeding the chance of exposure is high to thousands to million of virus depends of viral load at time of sex. 

 

  • High Risk Behavior

     

    1 in 4 don't know they're HIV positive  Testing rates in the United States remain low, researchers sayhttp://www.msnbc.msn.com/id/21425612/

     

    FDA warning against  "internet sales of bogus HIV test kit" http://www.fda.gov/fdac/departs/1999/499_irs.html

  • According to FDA "Consumers should be aware that there are numerous HIV home testing systems that are marketed on the Internet, in newspapers and in magazines that are NOT FDA approved. These tests claim to detect antibodies to HIV in blood or saliva samples and provide results in the home in 15 minutes or less. The FDA has not approved these rapid HIV-1 home test kits for use and marketing in the United States. Some of these HIV home test kits falsely claim to be approved by the FDA or manufactured in an FDA approved/registered/licensed facility."

  • "In a joint investigation conducted by FDA and the Federal Trade Commission, an unapproved HIV rapid home-use test kit promoted on the Internet and sold domestically was tested by FDA and, in some cases, gave false negative results"

    FDA Warning Letters for Unapproved HIV/AIDS Test Kits

    http://www.fda.gov/oashi/aids/testwarn.html

    This interesting  story was reported by FDA:

     

    "Sally" was afraid that she had been exposed to HIV. She didnít want to buy a test in the local pharmacy because someone she knew might see her. She didnít want to go to a clinic for the same reason. So, like many other consumers, Sally decided to purchase her HIV test from an Internet source. She took the test and was distraught to find that the result was positive. After several agonizing weeks, she went to her doctor who did a confirmatory test with a more sophisticated testing method Ė and the result was negative. Sally did not have HIV. The test she purchased from the Internet had not been approved or cleared by the Food and Drug Administration (FDA), so it did not include the required labeling for a confirmatory test and counseling after a positive result. "

  •                 For your convinent we have extended our phone lines
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                                  [323] 231-7400

                                  (323) 231-7400

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                   4524 S. San Pedro Place

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    Testimonials   (The following patients were seen recently in our clinic, and are just some examples of numerous

    other similar praises.)

     

    " I flew 3000 miles to see Dr.Arani, he was only doctor that identified my condition, moreimportantly he was very sincere during this ordeal". J.R   Florida

     

    After being declared HIV positive by one of the world’s most renowned medical institutions, I came to your lab for a second opinion. Within 30 minutes, you were able to administer and return the results of an FDA approved test that showed that the original lab had made a mistake. After a week, the original lab called to tell me that I was in fact HIV negative and that they had made a mistake. The piece of mind your facility provided was crucial in helping me get through one of the most difficult weeks of my life.

    Nic, Los Angeles CA 11/18/2008

     

    "Thank you for giving me all of the test and explanations....I looked on the internet for other centers. There are labs, but none had a doctor." T. Braz California"

     

    Today I went for my final test for my Hiv and STD test. It was negative. It had been over a year since the last risk encounter. It had been a worst year in my whole life. Fortunately, I found Dr. Arani and he helped me through this horrible year. So as all the nurses in this clinic had been a great support for me. He is not only my doctor, but my friend and my psychiatrist. I would like to have all my thank to Dr. Arani and nurses. 100% recommend to everyone who needan excellent Infectious Disease Specialist who is more than just doctor, but friend"L.J Los Angeles, California"

     

    .....With 4 weeks of  penile discomfort and negative Gonorrhea/ Chlamydia  test finally I was tested by Dr. Arani and he explained my Urethritis and he treated me and everything got cleared in few days ...."P.J Camarillo, California

    .. "I got tested with  commercial medical lab and I was positive for herpes. I was so stressed and I did not know what to do till I came and got examined and tested with doctor and I was explained that everything was fine !. I got so relieved....." Confidential Patient  Torrance, California

     

    "I came to Dr. Arani,...he was the only person diagnose my condition"

    E. Briceno  Panorama City, California  

     

    "It was amazing that they tested me for both HIV 1 and HIV 2 without needle with negative result in few minutes. "   Pacoima, California

     

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