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.
Note: This answer was last updated in July 2021 from an original post from December 2011.
Hi ..am purity i finished taking my pep on saturday and am having tonsils could this be normal …am freaking out
Hi Mohamed, as you and your partner have had all negative results there is no risk of transmission for anything.
Good morning Josh. How are you all . Yesterday was a meeting with the girl with whom I had exposure. And I did a quick panibo HIV test ab, which I bought from abbot and bears the CE mark for it myself, and it was negative. In addition, she is vaccinated against hepatitis B with three doses. As for me, I only vaccinated with two doses. After exactly 6 weeks of exposure and my exposure the condom had slipped off and I used pep after that exposure 7 hours later for 28 days. And she underwent rapid analyzes for hepatitis C, B, lowercase, and HIV after a month of exposure, and they were all negative, praise be to God. Do I continue with my life now… . Thank you
Thank you Mr.Josh. No problem ☺️. I have satisfied to consult with you so far. Much appreciate. Thank you.
Hi A, I am sorry but I can’t advise on these symptoms. At i-base we are no doctors or medically trained. It would be more suitable to speak with your doctor about this.
Thanks mr.Josh. I will go for second test after next few weeks. Now l’ve noticed that I scratch my itchy skin and clusters of liquid filled bumps appeared at the scratched area (on fingers, hand, toes and legs ankle). Also white coated on tongue. What do you think of these symptoms? Sorry to bother as I don’t have friends who’s medical knowledge. So I-base is my one and only place to relief my concerns. Thank you Mr.Josh.
Hi A, yes this means that you will need a second test. Already testing negative is a good sign but to be sure you will require a second test. Tonsillitis is very common. It is not a sign of seroconversion.
So what should I do mr.josh? So meaning to say that the doctor is wrong? Or the testing method in singapore is different from Europe? I have fever and tonsillitis started yesterday. Are these the symptoms? I was happy my negative result. . Shall I go back and see doctor again? Advise me please thank you Mr.josh.
Hi Mohamed, viral load tests are not used for diagnosis. These tests more commonly give false results. Antibody tests are the only tests used to confirm someones status. This is either a 4th generation antigen/antibody test which can be done from 6 weeks after PEP, or a 3rd generation antibody test but you will need to wait 12 weeks for this.
Thank you for replying. Josh . I really appreciate your help . No I don’t have anyone to talk with . I do a rapid test today thank God it’s negative I know it’s not the time but at least makes me feel rest for a little bit . I go ask about test in laboratory here in city I live in they said they have 4generation HIV test and HIV PCR test (viral load ) . My question is do I can make PCR test viral load if the window period of it short (CDC said 10-33 days but I didn’t find any information about testing this kinda test after pep ) and if yes which date after pep . And I’m really sorry for questioning alote . Thank you and God bless you all