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.
I have a question
Hi Kasaya, no you do not need to start PrEP immediately after PEP.
This is only a recommendation for individuals at high risk of transmission. There is no benefit of taking PrEP after PEP if you are intending to abstain from sex after or use other methods to prevent transmission e.g., condoms.
A 3 month mark after starting PrEP is recommended for testing as HIV screening is regularly done while on PrEP. As you have taken a course of PEP and are now 6 weeks after the last dose, you can confirm your status with a 4th generation test. You will require no further testing after.
The rashes you have mentioned are not likely to be caused by HIV. As you have taken a full course of PEP and are now over 5 weeks since the last dose, the time frame of symptoms for seroconversion does not fit for what you have suggested. As with any skin changes it would be recommended to speak with your doctor about any possible causes and they can investigate and treat as appropriate.
Today on 9th Dec 2024 marks my 6th week after the last dosage of PEP. I went for HIV test. Being on Sat, I was instructed to go back for the test on Monday of next week. I shared my story with the medical officer about my case on PEP. I was shocked to hear from the medical officer saying PrEP was supposed to be initiated to me immediately I completed the PEP dosage. I completed the PEP dosage on 28thOct. Ideally, since I got exposed to HIV from a HIV positive friend after the condom failed to work, I have never had sex at all. How come the doctor stated that on Monday they are likely to introduce me on PrEP for a period of 3 months then from their they will perform some tests on me. Is this right? What I know, PEP is initiated to those who have been already exposed to the HIV virus. PrEP is taken before you get exposed to HIV virus and the more you continue to expose yourself to someone whose status of HIV you know or don’t know you have to continue with taking PrEP. How come the doctors on Monday will be working to introduce me on PrEP and I told them I am not going to engage in sexual affairs soon. Is this how it’s supposed to be??? I need your advice urgently so that I may not regret later.
Secondly,
My body especially the arms, legs and thighs have been developing red few rash which takes sometime to go on their own. In the beginning of week 5 my body has been itching such that when you scratch the itching area, it swells a big bump that after few hours it goes on their own. I sometimes experience rise in the body temperature, fever. Which after few hours it relieves on its own without taking the painkillers. Could this be signaling the possibilities of PEP failure?
Hi Dyna, an antigen test kit will be conclusive after 3 months. It is a good sign that you have tested negative but you will require another test to confirm your status.
Testing: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Hi Josh
I just tested using the antigen test kit and came out negative after 65 days after exposure. Is this result conclusive. what are my chances here when i retest at 3 months?
Hi Nur, the test you have taken is conclusive when taken 42 days or more after the last dose of PEP.
If this is the case you can be sure that your current symptoms are not caused by HIV.
The symptoms you have mentioned are all very general and quite common. Have you been to speak to a doctor so they can investigate and provide suitable treatment?
Hi, I finished taking PEP on the 18th October, after that I developed rashes and my tonsils got swollen. Then followed by severe neck pain that seems to be inflamed. Then yesterday got mild sore throat which disappeared this morning. I don’t what’s happening because I’ve used determine HIV 1/2 and also stat-pak which came out negative. I’m seriously worried and this is the 50 days after PEP
Hi Josh how are You, i had sex with a lady whose status i don’t know, so i started taking PEP after 53 hours. 12 days after exposure (and ten after taking PEP) I started noticing a rash al over my chest ,belly arms and feet , i am really worried. Could it be a side effect of the PEP or i am getting infected?
Hi Juan, no this is not suggestive of HIV transmission.
As with all skin reactions it would be advised to speak with your doctor to discuss any possible causes.
PEP: https://i-base.info/qa/factsheets/pep-faq
Hi Trent, no these do not affect U=U. When on effective treatment with an undetectable viral load, the presence of other STIs will not cause there to be a risk of transmission.