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.
Hi Josh, I had a sexual exposure on 28th Sep 2022, after which I had PEP from 30th Sep 2022 to 29th Oct 2022. Then on 8th Nov 2022, I had a complete STD testing which included 4th generation HIV test, HIV DNA PCR test, HSV 1&2 IgM / IgG test, etc. All came negative.
Then on 14th Dec 2022, I had all these tests again. All came negative.
Then on 25th Jan 2022, I had a 4th generation HIV test which came negative too.
But then on 30th Jan 2022, I had tiny blisters on my penis and it looked like HSV. But I had HSV blood tests two times like I mentioned and they both were negative. But to rest my anxiety, I went for another test for HSV on 3rd Feb 2022 in a different lab this time and it came positive.
Now I’m paranoid that if my HSV test could turn positive after so many days of exposure and PEP, same can happen with HIV testing?
To clarify, I didn’t have any kind of sexual activity at all after my exposure on 28th Sep 2022.
My concerns are:
1. Whether or not HIV 4th generation tests 100% acurate even at 90 days after completing PEP?
2. If HSV was undetectable till 47th day after PEP, could same be the case with HIV too?
3. What is the maximum window period of HIV after completing PEP?
4. How can I make sure whether or not I have HIV, if even lab/blood tests are not reliable?
Please please please provide a detailed response on my concerns. I’m supper paranoid right now. Please help me answer my questions.
Hi Deni, as you have both tested negative there is no risk of transmission. You do not need to be on PEP.
So my case was
I’ve always update my hiv status regulary and my status was always negative, latest was in december
I have unprotected sex with female in january
She say that the last she was having sex with stranger is 6 month ago
Out of panic i went to clinic and started PEP 11 hours after exposure (my Regiment is TLD)
3 days later ive managed to persuade my partner to take HIV Gen-4 test and siphylis test as well
Turns out the result were both negative, so my question is there any chance that i got infected HIV
and im on 15 day of PEP should i stop or just continue (just in case)
My anxiety is beyond imagination right now
Hi James, no you should not be worried. These symptoms started too soon after finishing PEP to be a sign of HIV. PEP delays seroconversion. These symptoms would be expected to happen 1-3 weeks after PEP if caused by HIV. They are also very common symptoms and are more likely caused by a cold/flu. Testing at 4 weeks with a 4th generation test is 95% accurate. For a conclusive test you will need to test again at 6 weeks using the same type of test.
Hi JT. I had unprotected sex with someone with unknown status. I started PEP within 18 hours of possible exposure and completed a 30 day course (without skipping a dose). About a a couple of days after I completed my last dose I developed cold like symptoms (congestion, a mild cough), raised lymph nodes under one of my armpits and some rash on my hands (tho not itchy). No fever or joint pain/fatigue. All of these symptoms disappeared within a week. I am waiting for week 4 after completing my treatment to get tested. Should I be worried ?
Hi Jt, the most common causes of PEP failure are not starting within 72 hours and/or not taking PEP every day for the full course.
What can make pep to fail
Hi Tonny, while testing early can give some relief you still need to make sure you do a final test at 6 weeks after PEP. This will need to be a 4th generation test. Testing earlier can give reassurance and will be probable of your status. E.g. testing at 4 weeks is 95% accurate but this needs confirming at 6 weeks.
Please follow this link for information about dealing with stress and anxiety around testing: https://i-base.info/guides/testing/hiv-testing-feelings-of-fear-anxiety-and-guilt
Hi Josh thank you for getting back to me you are doing a great job to keep some of us calm… I just finished my doze today 22 January 2023, I’m still having these symptoms although they’re mild, flue that is mild, diarrhea, lymph nodes, soar throat and sometimes I cough. While I’m reading I see that we have to wait atleast 4 weeks after finishing pep to get accurate results, on my side I don’t think I can wait for that long and I am planning to go in as soon as I can for another test because I am panicking already.. The sources around internet are making it difficult for me. Thanks for giving us hope
Hi Tonny, this does not mean PEP has failed. The symptoms for HIV are very non-specific. As you are on PEP these symptoms are more likely caused by a different infection. Are you still experiencing these symptoms? As you are taking PEP, tests will not be accurate. You will be able to test from 6 weeks after your last dose using a 4th generation antigen/antibody test.