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.
Pls, help. This is 8th weeks after exposure and four weeks of finishing PEP. I still have diarrhea and a weakened body, rash. I tested on week seven with antibody test, it was non reactive. I don’t know what is happening to me, pls advice
Hi Jay,
If you’re no longer taking PEP then the rash has nothing to do with the meds your were taking as they’d be out of your system by now. It may be worth seeing a dermatologist.
If the risk was July 26th and you’ve recently had a non reactive test, this means that won’t be positive.
Hi I am Jay
I had sex on July 26,2019..I started pep on 27 July,2019…while on pep I had a cold that was 3weeks into the pep…I contacted my doctor I was given some cold medicine the cold resolved on the 5th day of the cold that is a day after completing the medication for the cold he told me not to worry, I developed a rash on my hands I showed my doctor he said not to worry and examined the rash I was given antihistamines the rash resolved but reoccured on my upper back he examined it and said it is the drug causing a reaction I saw him on the 1st of October and he ordered an antigen/antibody test the both came out none reactive he said he only did the test to calm me down that the test was meant for the 17th of this month the drugs used for the pep dolutegravir/lamuvidine/tenofovir..50gm/300gm/300gm.he said the rash was still as a result of the drug,but my concern is it’s been a month and some weeks since I used the drug if it’s a drug rash should it last this long..the rash itch sometimes and are localised to my upper back and like 6 of them on my shoulder
Hi Selam,
If you’ve tested negative, there’s no need to take PEP again, another course that is. If you still have a rash, you’ll need to see a doctor about this.
hi guys i am take pep for the last one month but there are rash ,musle ache and cough.is it the side effect of medication or other? i take medication lamuvidine(300mg),tenofovir(300mg),dolutegravir(50mg).after i finshed pep ,i checked and it was negative,is it important to take pep medication for second time? .is the medication treat hiv1 and hiv2?
Hi Tony,
If you’ve had a positive as well as negative test you’re going to need to have a third test. This test should be done in a clinic.
Hi, please this is urgent. I’ve tested both negative and positive within 4 days and I’m really stressed and tensed now. Please can you tell me if there’s any reason to this.
Hi Sipho,
I looks like it means you’re HIV negative. Please see this link for HIV tests and window periods to check you’ve had the right kind of HIV test at the right time.
Hi guys I was exposed to HIV positive person i went to the Doctor he gave me a prescription of Truvada and Edurant. On the second of April 2019 I was testing negative and now am still testing negative so what does that mean
Hi Elna,
It’s good that you’ve started PEP if you think you’ve been at risk of HIV.
But sorry, I’m not sure what the pills are. It’s a good idea to contact the hosptital and ask them.