Q and A

Question

Is my combination suitable to be used as PEP?

11 January 2023. Related: All topics, PEP/PEPSE.

Today I can feel a lymph node at side of neck I believe. I can’t move it but I can feel the bump. I am concerned and also I am worried about the PEP which I am taking i.e TAF/FTC/DTG. I heard it isn’t recommended as PEP as studies haven’t done as PEP.
Please give your valuable comment on this PEP regimen and new symptom.

Answer

Answer: Josh Peasegood

Hi, how are you?

Your course of PEP is suitable. In most cases PEP is required to be a 3-drug combination which you have. The small difference between most is that you are using TAF and usually people will use TDF. TDF and TAF are largely the same drug but TAF has fewer side effects on kidneys. It is recommended to continue with your course.

An enlarged lymph node on the side of the neck is not suggestive of HIV/PEP failure. There are a number of causes for this. Are you experiencing any other symptoms? As you are on PEP. HIV symptoms would be delayed until after you stop if there is a failure.

Please see this link for more information about PEP:
https://i-base.info/qa/factsheets/pep-faq

Josh.

12 comments

  1. Simon Collins •

    Hi Tt, please see this link for info on testing:
    https://i-base.info/qa/11844

    thanks

  2. tt •

    Hi Josh.
    Tested at 40days after PEP with ag/ab test and in method it is written ECL/Sandwich.
    so is it 4th gen test right and yes it came back negative.
    So I have one more que , is it possible 4th gen test misses ab and when get tested on same day with ELISA and become positive?

  3. Josh Peasegood •

    Hi tt, at 29 days using a 4th generation test the result is 95% accurate. This means that it is very likely you are HIV negative. To confirm this result you will require a second 4th generation test in 2 weeks (6 weeks total after exposure).

    The window period is not different for HIV 2. A 4th generation test is conclusive from 6 weeks regardless of the HIV type.

  4. tt •

    hi josh,
    tested at 29th mark with 4th gen from vein.
    and it came back NEGATIVE.
    what r chances of it becoming positive?
    but now I heard for HIV2 window period is different and PEP doesn’t prevent HIV2 and it only works for HIV1. IS IT TRUE?
    or test at 6weeks will be conclusive for both HIV1and2.
    I belong to INDIA and heard HIV2 cases are on rise here

  5. Josh Peasegood •

    Hi tt, while suppressed HIV is not having an effect on the body. Even undetectable, 4th generation tests will still be positive. An undetectable viral load does not mean that someone is HIV negative.

  6. tt •

    thanks again for the answers.
    i got one que again sorry for that.
    suppressed viral load can also cause symptoms?
    actually my understanding was if viral load can cause symptoms then it can be detectable by RNA or 4th gen test despite of being on PEP

  7. Josh Peasegood •

    Hi tt, while on PEP a positive test is accurate. Testing negative while on PEP is not accurate. PEP can suppress HIV and cause false negatives on tests. This is why testing after PEP is needed.

  8. tt •

    thanks for answering the que.
    I want to ask one last que.
    As I read in above article HIV RNA PCR can be used when person is showing symptoms and this result can detect HIV.
    but we can trust this test when person is showing symptoms while on being PEP right?

  9. Josh Peasegood •

    Hi tt, for a conclusive test you will need to use a 4th generation test 6 weeks after your last dose of PEP. Please follow this link for more information: https://i-base.info/qa/factsheets/hiv-transmission-and-testing

  10. tt •

    in short, had sex with spa worker with condom but not sure about condom break then started pep i.e TAF/FTC/DTG at 23rd hour of exposure. then on day 15 of PEP noticed lump in neck took sonography it was cervical lymph node of size 14*8mm and started feeling of fever but thermometer showed normal temp and then developed sore throat which is still there after 15days and since then feeling dizziness and in day27 of PEP noticed palpable lymph nodes in groin area but when showed it to doctor he said it’s fine and of normal size but still feel some pressure in that area(inguinal i guess) radiates till thigh and lower back.
    Tests: first i got tested out of fear on 23rd day of PEP with HIV RNA and 4th gen test which were negative and then one more 4th gen one day after completion of PEP which was negative and still have sore throat and dizziness in the day.
    one more que I have – if these symptoms were of seroconversion then RNA or 4th gen would have detected right!