Question
Does PEP delay seroconversion?
24 December 2021. Related: All topics, PEP/PEPSE.
Hi, I had an exposure in early October.
I took PEP (TDF + FTC + DTG) after 5 hours of the exposure. I did not accompany the doses with meals, I took them alone with water or some drink. Can this interfere or reduce its effectiveness?
Does PEP delay seroconversion in case of failure? At 5 weeks after finishing PEP swollen lymph glands in both armpit.
Answer
Hi, how are you doing?
PEP does have the potential to delay seroconversion.
As PEP works similar to medication used to manage HIV, PEP if unsuccessful can delay seroconversion.
This is why testing a minimum of 4 weeks after PEP is required. Seroconversion can occur 1-3 weeks after the course ends. Only 80% of those who do seroconvert in failed PEP will experience classical symptoms e.g., fatigue, fever, headache etc.
Five weeks after finishing PEP would be later than expected if this was really HIV. Swollen lymph nodes can arise from a number of infections, not only HIV. Is this symptom being managed by a doctor?
The combination you have taken can be consumed with or without food. This would not have impacted how well it worked as PEP.
If you have another question do ask,
Josh.
Hey Josh, I was wondering if you can help me, please?
On May 21st I had an incident (I engaged in mututal masturbation with a guy in my gym sauna and he inserted the tip of his finger in me for a few seconds until I told him to stop, it was not deep and very brief, I think there is possibility he may have had precum on his finger) and I called PEP line in Australia on the following day but was refused the PEP regimen. On the following day I went to a sexual health clinic and begged them to give me the PEP regimen and they gave me, so I started it after 40 hours.
I asked for risk assessment on Poz Forum and they’ve told me I had no risk, no exposure, no test required and certainly no PEP. But even so for peace of mind I took PEP until the 19th June (28 days). But the clinic I got PEP from wants me to test only on August 22nd, I am going crazy with all this waiting. Why the testing date differs so much from place to place? When you say 6 weeks is the guideline where do you get this info from? Is it safe to say that a 4th gen test is conslusive after 6 weeks?
I got referrals for a 4th gen Ab/Ag from my GP and I have been testing since I finished PEP for my peace of mind. All my results were negative so far (Last one was at 3 weeks post-PEP). Using the same test will my 6th week post PEP be conslusive? I cannot deal with this waiting anymore.
Hi Jackson, no this is not suggestive of seroconversion.
Finished PEP, 7/6 after following 28 day course. Had a high risk exposure. Only had a variation of 2 hrs of dosing time, a couple times.
Today 7/11 at noon I got fatigued, then around 8-9 pm I got really hot, then the chills.
It’s been 5 days, could I be experiencing seroconversion?
Hi Alex, it is great that you have been testing negative. You will need a final conclusive test on 8th August or after. This is because a confirmatory test is required 6 weeks after the last dose of PEP using a 4th generation test. It is still very encouraging that your current tests have been negative.
Tonsillitis is not suggestive of HIV transmission/seroconverion. Tonsillitis is a common infection and having recently taken PEP should not make you think HIV is the cause.
Hello, my exposure was on May 29 at 9 p.m., Monday May 30 at 10 p.m. (25 hours) I started with PEP (Truvada and Dolutegravir) for 28 days, I took the 2 pills daily without forget none and always at the indicated time, on June 26 I took a 4th generation test in a laboratory and it was negative, on July 3 I took another 4th generation test in a laboratory and it was negative. At 3 and a half weeks after the exposure I had tonsillitis with many white plaques with a bad smell, I took azithromycin and the tonsillitis lasted 3 days. Could I be infected with HIV?
Hi Maria, TLD is most commonly the ART combination used for PEP. If this was the case TLD and Trazodone do not interact. There would be no impact of Trazadone on causing PEP to fail.
Hi doctor I took pep and was taking trazadone is that make pep to not work?
Hi Ravi, as mentioned in the fact sheet, these are old guidelines. It used to be recommended that when testing after 4 weeks a second test should be done 2 months after. This is no longer the case.
One test at 6 weeks is sufficient. Even if you take the first test at 4 weeks, a second test would still be required at 6 weeks to confirm the result.
This information only applies for 4th generation antigen/antibody tests.
I have a question. Why the fact sheet says that if you take the 4th Generation antibody test after 4 weeks of PEP, you need to take another test after a month later. Is it okay to take test after 6 weeks of week instead of a month after, if you are tested at 4th week after PEP?
Hi Ravi
Please see this link that answers your questions about PEP, including about symptoms.
https://i-base.info/qa/factsheets/pep-faq