Question
Is PEP effective if taken 48 hours after exposure?
2 July 2021. Related: All topics, PEP/PEPSE.
I paid for sex with a woman but the condom tore and I only realised after I was done. There is a high chance that she was HIV positive. I started PEP after 48 hours.
I got a PCR test done 17 days after exposure. It had a less than 20/ml (undetectable) result.
Now between 14 and 35 days after exposure I have had signs of thrush, mild red rash on my face and a couple elsewhere. But no fever or swollen lymph glands.
Can the rash and thrush be because of utter stress and obsession?
My doctor says that the PCR can be relied upon and that I am negative.
Can the PEP have reduced the viral load to less than 20/ml as I took it for 15 days before the PCR test?
Please give your expert advice. I am very anxious. Thank you.
Answer
Thank you for your question.
The risk of HIV from one broken condom is very low. If your partner had an undetectable viral load on treatment, then the risk would be zero. If they were not on treatment the risk might still be only 1 in 300 or lower.
You cannot guess someones HIV status so your assumptions might also be wrong.
You started PEP within 48 hours, so it is likely it will work.
PEP – stands for Post-Exposure Prophylaxis. It is a term used for taking HIV drugs to reduce the risk of infection. PEP usually involves taking a combination of three HIV drugs for one month. The earlier PEP is started, the more likely it will work. Ideally, this should be within a couple of hours. If this is not possible, then still the earlier the better.
Some guidelines include a two-day window to do this (i.e. within 48 hours). After this, effectiveness is much less likely. Other guidelines allow up to 3 days (i.e. within 72 hours). Sometimes this may be more for psychological benefit. For example, if someone is very stressed or traumatised.
No guidelines recommend starting PEP after 72 hours.
After finishing PEP you need to wait a 4-6 weeks before testing.
If the PEP has worked, or the person was not initially infected, this will show as a negative HIV test. The test you did 17 days after the exposure will not be accurate yet.
If the PEP has not worked, this will be shown in a positive test result. Testing 4 weeks after PEP will detect 95% of infections. Testing after six weeks will detect more than 99% of infections. This result doesn’t need to be tested again.
If PEP has not worked, serosonversion usually occurs 1-3 weeks after PEP is finished. However, only 80% of people show symptoms.
Please test 6 weeks after you finished PEP is finished. If you test any earlier, you need to take a second test 3 months later.
Viral load (PRC) tests are not approved to test for HIV. In some cases they can have a role.
Please see a doctor to talk about your symptoms he best way to confirm what is causing them is to see your doctor. He/she will be able to diagnose and treat the symptoms accordingly.
Please see this link for more information about PEP:
https://i-base.info/qa/factsheets/pep-faq
Note: This answer was last updated in July 2021 from an original post from December 2011.
I had sex on the 23 August 2019 at around 21:00 and the condom broke on the 26 August I went to the hospital for PEP prescription. I was given lopinavir/ ritonavir and 3 blue pills on the 27 I went again to the hospital and I was given white pills. How is my chances of getting HIV? What are the white pills for and do they work in the same way as the first blue pills?
Hi Surag,
A duo test is very accurate. So it looks like you’re HIV negative. But a very small perentage (only 1%) of people may have a delayed response after 2 months to HIV. So if you are very tense, you can confirm the negative result after another month.
Hi I am suraj.
After eight week to finish my pep medicine. I go for hiv duo test and the test result is nonreactive .
But after the second day of my test result I got fever , sorethorat , mouth ulcer , cold and cough , muscle aches , night sweats . I don’t know it is viral infection or hiv infection.
My question is can seroconversion is possible after 2 month .
What u tell about my symptoms can it is hiv symptoms.
Last 2 month I got three nonreactive result. But after the illness I am very tense .
I don’t sleep properly in night.
What u suggest for me.
And what u sad about my test result.
Hi Rahul,
This is an antibody negative result. To confirm this result you need to take another test 3 months after finishing PEP because of the small chance (less than 5%) that you haven’t yet developed antibodies to HIV.
Please see this Q&A for more info about different tests to test for HIV.
Hi I am rahul .
After 9 week to finish my PEP medicine . My HIV test result is nonreactive and index value is 0.07
Can it is accurate for me
Hi Caramel,
A course of PEP is for 28 days. Please see this link.
And as it says above, the earlier PEP is started, the more likely it could work. Ideally, this should be within a couple of hours. If this is not possible, then still the earlier the better.
Please guys help me out, how much is PEP treatment
How much do i need to have when im prescribed PEP
Hi Zoleka,
Firstly, many congratulations on having a new baby girl.
It’s good that you are on ARV treatment, and is that with an undetectable load too? Your daughter is taking nevirapine, and you are not breastfeeding her. So it sounds like you are doing all that you can to look after her health.
But please take her to see the doctor if she has flu, that’s because flu can be serious for very young babies. You can discuss the best way to help with her blocked nose too.
The breastmilk was probably a tiny amount and low risk. But you can also check this with your doctor and you can tell them exactly what happened.
Hi
I am HI V positive and I have a newborn but then I don’t breastfeed her
But my angel woke up with her nose blocked as she is getting flu
Then I squeezed the breast milk into her nose trying to unblock her
Will my baby be infected?
As m On ARV treatment and she is also taking her Cipla Nevirapine medicine
Is my baby on risk of being infected?
Hi Negative,
Are you taking a PI as part of PEP? Stomach upset is a reported side effect of boosted PIs. What does your doctor say? You can ask to change to other PEP meds, such as an INI (integrase inhibitor), if the side effects are bad.