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.
Thanks Josh.
And can I really trust what you and people from Poz forum are telling me? From your experience what happened to me wasn’t a risk?
I have been struggling with OCD and depression, just want to leave this behind and stop testing.
Hi Jake, yes your result is conclusive. As there was no risk in your potential exposure this test will provided a conclusive result of your status.
Hey Josh, so would you say it’s safe to take my last negative test at 5 weeks post PEP conclusive since I was told I didn’t need PEP? I just need some peace of mind, having a hard time believing what I was told on the internet. I know the i-base is a serious organisation so just want to make sure I can safely move on.
HI Jack, HIV is not transmitted how you have mentioned. There was no need for you to be on PEP. Please see here for information about transmission: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
One of our new colleagues got diagnosed with syphilis and Hiv.Was with us only a month.He used to be with as all time.We shoke hands frequently and I have habit of pooping pimples and putting pen in mouth.I frequently have chapped lips.When he was diagnosed I started taking pep.on pep I developed red spots on my hand after they gone after 10 days while on pep I had a sore inside my lip corner. Now I have finished pep and its my 7th day.I have hell of anxiety and keep myself checking for fever sores and rashes all the time.Can you please tell were those symptoms of acute hiv and how much are chances.
Hi Kodojo, please follow this link to the i-base PEP F&Q: https://i-base.info/qa/factsheets/pep-faq
Hi there!
I was bitten severely in the shoulder and I started bleeding from the wound caused by the bite. The biter had some blood in his lips. I started PEP 23 hours after the incident, which was delutegravir, lamivudine and tenefovir. Exactly 7 days after I started taking PEP I started sneezing, having runny nose and feeling cold, no fever. However, next day, that is, 8 days after I initiated PEP, I developed a boil on my right side buttock and which was swelling gradually until I drained it. And 2 days after I developed the boil, that is, 10 days after I started PEP, I started having watery and smelly diarrhea and started feeling like I have fever but When I put my hand on my forehead I don’t feel it to be hot. And 4 days after I started having diarrhea, that is, 14 days into PEP, I developed 3 other boils close to where I developed the first boil. However, these 3 other boils, even though they have heads and are somehow itchy, are not growing in size, are much much smaller than the first boil, which I am still draining and which is very itchy.
So, currently I am on day 17 of the PEP and what I have is the following:
A) a big boil on my right buttock, which I am still draining and which is itchy
B) 3 other boils, which I developed 4 days I after I developed the first boil, and which are not growing in size, that is, they are much much smaller in size than the first boil that I developed, in the same location.
C) Watery and smelly diarrhea and nausea
D) I feel like I have fever. Now I am going to the pharmacy to buy a thermometer to measure my body temperature.
My questions are the following:
!) Can these symptoms be the symptoms of acute HIV assuming that the PEP failed?
2) If PEP fails from the start, when are the symptom of acute hiv infection or seroconversion going to show??
3) Will the symptoms of Acute hiv infection be delayed if PEP failed from the start??
4) And can PEP lessen the severity of the acute HIV symptoms?
Hi Jake, yes you did not need PPE. Tests are conclusive after specific time windows. More about testing can be found here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
There is no specific week in which people would seroconvert if PEP fails. This is why there are testing windows as explained in the link attached.
Thanks for the quick response Jake. So you’re saying that in your opinion I didn’t need PEP? I am so scared as I have a swollen lymph node under my chin for a few weeks. If this was HIV related the testa would have come out positive, right?
And another question, usually if PEP fails which week mark they usually seroconvert and shows positive on a test? Do you know this information?
Thank you!
Hi Jake, as Poz Forum mentioned there is no risk of transmission. PEP was not required in this case. Testing times defer based on the type of test, time of accuracy and if you had taken PEP. PEP delays the time of testing windows by the duration of PEP.
The earliest you will be able to test is with a 4th generation test at 6 weeks after your last dose of PEP. This result is conclusive. You can use the same test at 4 weeks but the result will only be 95% accurate and a second test would be required at 6 weeks.
Please see here for more information: https://i-base.info/qa/factsheets/hiv-transmission-and-testing