Question
Does PEP have side effects?
5 February 2018. Related: All topics, PEP/PEPSE, Side effects.
Hello,
I am confused with PEP treatment, specifically about the side effects.
From sexual health charities I hear that PEP treatment can cause occasional side effects which may or may not go over the 28 days treatment. Another one (THT) says that the side effects are extreme and about 1 in 5 people on PEP stop taking it as a result.
The sexual health nurse said that side effects on PEP are very common and are severe.
I’ve heard from 3 people who have had PEP and they said that they didn’t get any side effects.
What’s the official line on PEP and side effects? I thought that PEP usually uses recommended triple therapy, using drugs that are well tolerated. Is the conflicting information I am receiving due to outdated data or current data?
Thank you for any clarity you provide.
Answer
All meds have some risk of side effects, but for PEP this risk is usually low. If side effects do occur, they are usually mild.
This depends on the meds used in the PEP combination.
In the UK in 2018, the PEP combination is usually raltegravir plus a combined pill with tenofovir DF/emtricitabine, which generally causes very few side effects, if any.
Even general side effects like nausea, diarrhoea and tiredness are not experienced by most people.
If mild side effects occur, they usually get easier after the first week or two as your body adjusts.
PEP that contains a drug called efavirenz is not recommended in the UK, though is used in some countries where there is less choice for HIV drugs. Efavirenz has a higher risk of side effects including mood changes and vivid dreams.
Discontinuation rates for PEP are often not very good. Studies of health workers who are exposed with a needle-stick injury report many people stop before the full month of treatment.
Note: This answer was updated in February 2018 from a question first posted online in June 2009.
Hi Tesh,
Thanks again. It’s good that you tested negative twice. Here’s a chart showing how different people produce antibodies at different rates. After 12 weeks the test is considered 99.9% accurate.
The first HIV protein (antigen) that can be measured is p24 (from 1 to 8 weeks after exposure). Viral load and p24 tests are not accurate for diagnosing early HIV if the results are negative.
Hai guys thank you so much for your response towards our comments.
I took a 4th generation test as mentioned in the paragraph below. I took the test twice after 28 days of pep and after another 28 days again. Both test are negative.
4th generation tests are accurate 3-4 weeks after exposure, because this is when the p24 antigen becomes high enough to measure. Everyone makes antibodies at slightly different rates so to make sure the tests are accurate they air on the side of caution and say you should get the tests done at 28 days.
So this does not mean anything?
Hi Respo,
As Angelina says on this Q&A, 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 three months after PEP will detect more than 99.99% of infections and is considered confirmation that someone is HIV negative.
Is it possible for you to talk to your doctor again about your stress and anxiety?
Thanks for your replying me.
Doctor told me that it is anxiety cause these symptoms. but I don’t know if the anxiety can cause those symptoms.
is the possible that 5% of infection remaining to be Free produced HIV antibodies. or should I feel Free Right now instead of wait another month.
Hi Respo,
It’s good that you tested negative more than 28 days after finishing PEP. This can pick up 95% of infections. However, the remaining 5% can take longer to produce HIV antibodies.
What does the doctor say about your symptoms? As they are not going away, can you see the doctor again?
I had protected sex with infected person and I had three open wounds on my hands.in time of removing condom Her vaginal secretions go on my hands open wounds and her viral load was detectable and she was not on treatment.
1.how I am risk to HIV positive?
I took pep in 24hours after exposure(efavirenz, lamivudine and tenofovir). I take it full monthly.i after 1 day of month of pep I tested negative and at five weeks after exposure I had some symptoms like headache, sore throat, swollen lymph glands, night sweat, dry cough, sore and ulcers on my tongue and muscles pain on my neck and sometimes joints pain and also my white tongue.i went to my doctor to look what cause those symptoms, he find that no illness I had. after 6 weeks of exposure I test again negative and now test again it was 60 days after exposure I test again negative but the symptoms does not go away.
2.is that symptoms means that I will be HIV positive???
please I am asking help I am so scare
Hi Tesh,
Thanks.
Yes, the test 28 days after finishing PEP will pick up 95% of infections. The other 5% will produce antibodies within 3 months.
Ok sorry for many questions. Its just that I have no place else to ask for questions and my health advisor is always irritated or does not want to discuss things.
Can I please just ask the last question.
After my 28 day of pep I got tested with a 4th generation test and 3 weeks after I got tested with elisa test and 28 days after pep I tested again. All test were negative. Is it still possible for this to become positive in the future..?
Please bare with me and im sorry for many unnecessary questions.
Hi Tesh,
Thanks. As Lisa says a person starting ART should be undetectable in about 1 – 3 months. And please see this link which has info about PEP and HIV testing.
Hi Lisa
Thank you for replying to my previous emails.
You guys are doing a great job to inform people.
So I got a rapid test done two weeks after pep and the 3rd week after pep l got an elisa test done. Both test were negative. Is it possible for this test to go turn positive?