Question
Can TLD be used as PEP?
5 January 2022. Related: All topics, HIV transmission, PEP/PEPSE.
Can TLD help someone who has been in contact with an HIV positive person to prevent them from contracting HIV before 72 hrs?
Answer
Hi, how are you?
Yes you can. TLD is a combination that can be used as PEP and for the management of active HIV infection. PEP stands for post exposure prophylaxis. PEP is used to prevent established infection after exposure.
TLD is a first choice recommendation for PEP. The course lasts 28 days following a high risk exposure. It is only used in cases where the exposure was within 72 hours. After this, regardless of what drug is prescribed, PEP will not work.
However, if your partner was using effective HIV treatment (ART) , you will not be at risk. Having an undetectable viral load on ART means HIV is not a risk. Please see:
i-base.info/u-equals-u/
If you have any more questions please ask,
Josh.
Hello Josh,
Thank you very much for your prompt response!
I still have a doubt: what do you mean by “as long as you have 2 days remaining, you will be protected from”?
Hi Fer, no you do not need to extend the course of Acriptega. You can finish your course of PEP when expected.
Being on PEP will work like PrEP for the duration of the course. This means that any subsequent exposure you have during the course, as long as you have 2 days remaining, you will be protected from.
More information about PEP can be found here: https://i-base.info/qa/factsheets/pep-faq
Hello!
On January 30th of this year, I had unprotected sex with a person whose serological status I didn’t know. The next day, in the afternoon, this person took a rapid test, and the result came back positive. My serological status at that time was negative since I had recently tested, considering a window period of 22 days without engaging in any sexual relationships with others.
As soon as I learned about it, I went to a hospital where they provided me with Acriptega (I’m from Chile) for 28 days. I started taking it a little before 24 hours had passed since the exposure, and since then, I have taken it daily at the same time.
On the second day of PEP, I had unprotected sex with someone who told me they were on PrEP.
On the fourth day of PEP, there was unprotected sex with another person who told me they were on PrEP.
On the sixth day, I repeated the same with a different person, who also told me they were on PrEP.
I am a man who has sex with other men, and in all three instances, I was the insertive partner (top) and used ample lubrication.
My questions are:
Should I be concerned about possible virus transmission to my body? Considering that the exposures on the second and fourth days were with people I met through an app, and consequently, I don’t know if I can trust that they are indeed on PrEP. I can confirm that the person on the sixth day is on PrEP.
In the same line, should I continue taking Acriptega for more days than instructed?
Thank you very much for this platform you have created.
Hi Deeba, this is a very low risk exposure. Using a condom for penetration and this person being more likely HIV negative than positive makes this a very low risk event. Completing the course of PEP (aside from the last day) reduces this risk to as low as possible. You have a very low risk.
More information about risk can be found here: https://i-base.info/guides/testing/risks-for-transmission
Hello..pls I had a protected sex around 11pm with a lady which I don’t know her status and she refused to do HIV test with me..She was on her menstruation when we had sex I sucked her without knowing then swallowing some blood and she removed the condom to stroke and played with my penis with her hand full of the menstruation blood then later I put on a new condom to penetrate. I used condom during the penetration..it was dark and I couldn’t see what she was doing ..the next morning I went for PEP .I got TLD took it for 27 days as I miss the last dose due to my work ..pls am I at risk
Hi Erick, no this will not reduce the effectiveness of PEP. Why are you taking Septrin alongside PEP?
Do you know how well your kidneys work? If you have not had any problems with your kidneys, it is safe to take them together. But Septrin can increase how much lamivudine (L in TLD) is in the body. When you have poorly functioning kidneys, this can cause problems and needs a little more monitoring by your doctor.
Hi Josh, ,,,I took my first dose of pep TLD with septrin together. can this ruduce pep effective?
Hi Erick, no this is not true. TLD is an effective medication that can be used as PEP.
Hi Josh! Is it true that TLD is not good used as PEP?
Hi John, TLD can be used as both HIV treatment and PEP. When used as PEP it is prescribed as a course of 28 days (sometimes 30 as in your case) and is used to prevent transmission after an exposure. Your doctor has given you the right treatment.
More information about PEP can be found here: https://i-base.info/qa/factsheets/pep-faq
As this girl had treatment themselves, it makes this a low risk encounter (if she did have HIV). Being on treatment will suppress viral load. In most cases people find their viral load becomes undetectable. When this happens it is impossible to pass on HIV via sex even without a condom.
This is called and explained by U=U: https://i-base.info/u-equals-u/