Question
So many questions about HIV testing after PEP…
2 September 2024. Related: All topics, PEP/PEPSE.
Answer
Hi there
The Qs below are not clear but all came anonymously within a few days of each other, so are from the same person.
They also seem linked to this Q&A and the related comments below:
https://i-base.info/qa/23811
Please include your email if you would like to discuss anything. Any more anonymous emails about PEP will not be answered online.
The short answer is that PEP is very effective. Symptoms while on PEP are not HIV. Testing is recommended 6 weeks after the last PEP dose in the UK, but other countries have different guidelines.
Please see this link for information about PEP:
https://i-base.info/qa/factsheets/pep-faq
Q1:
Sorry for asking this question! I would like to ask why the post-PEP follow-up instructions are getting shorter and shorter from 6 months to 4 months to 12 weeks and then to 6 weeks? while recovery and seroconversion after Pepe are generally unchanged compared to with the first studies on PEP. Please answer me why there is such a change?
Q2
Hello I have heard about testing after 6 and 8 weeks of pep but I don’t trust those instructions so I will still test myself because I have heard of people controlling the virus after treatment 1 long time.
My question to you is if I am a post-treatment control, will antibodies be produced if the virus is not detected by viral load testing?
If I am in control after treatment, at some point the virus will definitely recover, can I treat it with the pills I use for pep?
Q3
The guidelines from your country and other countries are just a lie to deceive people when pep has no clearly proven effect. It only prolongs the time for discovery. 6 weeks is a fear of a lie. Science has proven that if it’s too much, pep is useless and only prolongs the window. You guys lied to us.
Q4
Thank you for being on this website! but let me ask, is the window of time for someone who has used pep indefinitely? and if you have used pep, it can never be determined with certainty, right? ? Because there are actually documents that say that very early treatment from 2 or 3 days will lead to long-term suppression with no virus in the blood and no body infection. At some point the virus will appear. It could be 1 2 3 years or longer because it’s random.
Is the medicine for pep also the medicine for treatment?
I had to take 2 months of LTD, only 1 month apart, so I’m very worried and don’t know what to do. Please tell me when I will have to stop it?
Q5
Please tell me I have taken Pep seriously and was re-tested 8 weeks after the last dose of Pep using the fourth generation test. But now I have symptoms of inguinal lymphadenopathy. Is it possible to have symptoms? Is the symptom I have HIV after I tested after the recommended window?
Q6
Is it true that once I use Pep, the post-PEP test is indefinitely? How long do I need to wait to get confirmed results or am I always in a 50/50 state because the virus must be in the blood to have antibodies? Can it be true that pep or arv strangely inhibit that
Q7
Can you tell me if there are cases of seroconversion due to Pep failure detected after 24 weeks? Are there still cases? Is testing for Pep after 6-8 weeks too early to make a conclusion?
Q8
Hi, can you give me instructions on the longest time I have to wait to get a conclusion after pep? Could it be from a few countries and from the first instructions?
This link covers all the above Qs about PEP, including the timing of testing.
https://i-base.info/qa/factsheets/pep-faq
UK and US guidelines both say that a 4th generation Ag/Ab test is accurate 6 weeks after sex. If you used PEP, the 6 weeks starts from the last day you took PEP.
This link includes more info about HIV testing, HIV risk and PrEP.
https://i-base.info/qa/11844
This info there is very good and is based on the best evidence.
If you are worrying about your test results, please talk to your doctor or test centre. The Q&A service is set up to help people living with HIV with questions about their treatment.
Thank you for your posts but comments on this thread are now closed.
Hello K and many thanks for your question.
If I understand correctly you are now 12 weeks (or more) after you had sex and have tested in every possible way for HIV and all tests have back negative.
Based on the above, no you don’t have HIV.
Your symptoms are likely related to something else.
Have you got treatment for ureoplasma? This is generally an infection that doesn’t have symptoms but it might be good to get some treatment for it, if you haven’t already.
I believe it’s best to have a full screen (my apologies I am based in the UK and we use different types of names for the tests, so I wouldn’t know what you were tested for under STD panel 1 or 2) including throat swabs.
I am sending you a link with more information about HIV testing to get a better understanding:
https://i-base.info/guides/testing
Hello, I had an exposure on April 14th with a CSW, I used protection but not sure why, the condom broke (i pulled my foreskin before wearing the condom). After 1 or two weeks, I had a burning sensation in the penile area so I checked with a urologist- he gave me doxycycline and Uripas. After that I also felt some burning but not severe, and sweating. In fear I had an STD panel 1 using urine after 32 days. Everything came negative, except ureaplasma parvum DNA detected. So got checked for hiv duo test after 72 days non reactive (0.07). Because I have been sweating all the time and have some throat sensitivity which didn’t stop, I took another same HIV duo cmia -non reactive (0.05) after 93 days. But this sweating and throat sensitivity under jaw line persist, so still in fear took quantitative PCR test which came undetected, LOD <20 copies. I have been sweating all the time in forehead face and neck area and the throat sensitivity reduced but still I feel it sometimes, but this sweating on forehead is non stop even while sleeping or sitting under fan, please help me
Hello Ben and thank you for the question.
First of all, the symptoms you are mentioning are not HIV specific.
Any kind of disease could have similar symptoms to yours.
If I understand correctly, you have had a negative test after 12 weeks of PEP.
That means it’s very unlikely your symptoms are related to HIV.
I would suggest visiting your GP to discuss this further.
Secondly, It is true that some conditions make it harder to diagnose HIV.
An HIV positive test is always confirmed with a different type of test.
When someone is tested they should inform the healthcare workers of any conditions they might have – that will allow for the right test to be used.
That minimises the risk of a diagnosis that is not accurate.
Here is a link to explain the accuracy of HIV tests:
https://i-base.info/guides/testing/test-accuracy-results-and-further-testing
The prevention tools we currently have are very effective, especially when they are combined.
So, testing every 3 months (that is good practice) and using PrEP or PEP work very well together.
Here is a link for more information:
https://i-base.info/pep-and-prep/
This question is triggering another thought. It has never been this bad a worry with me especially after 12 weeks post PEP. Ever since I had fever past 2 weeks ago, I have not returned to my normal. Weight down, spot pain in the groin, stomach line pain, part pain on head and yet negative test. Why I differ from your belief a little is cos even if pep supresses the virus, it can’t stop the body from producing antibody to fight an “attacker” of the immune system. I also learned that a window period of 24 months is for those who are aware they have immune system compromise like those on chemo and so on.
Now I’m always taking excuse from such my sensitive office. Too many thoughts
Dear Bihn, the links are about how HIV testing works. This is the same whether you use PEP or not. The only difference if you used PEP, is that the window period starts from when you finish PEP, rather than when you had sex.
Your expectations for the test though are not realistic in how any medical test works though – which I why I sent you the link.
It sounds very reasonable to just want a test to tell you with 100% certainty whether you are positive or negative by a certain time. Unfortunately this isn’t how medical tests work.
Testing also works in a social setting of what is generally acceptable and also learning to live with small elements of risk, just like every other aspect of life.
I thank you very much!
The links you mention here are for non-pep users, not with pep!
I tested 16 weeks after the last pep dose with negative ag/ab. but it’s probably pointless as there isn’t anything that can tell me if I’m infected or not. everything I got The answers are as you said good enough, good….but all are not definite answers. I’m trying to wait until 24 weeks or I will test even longer if still negative. that’s why why I don’t trust the instructions because people are not sure about it
Hi Binh, thank you for writing back – I could see you were worried and so it is easier to answer now that I understand your situation.
Please see this link which explains the window period:
https://i-base.info/guides/testing/what-is-the-window-period
Figure 7 is a graphic to explain this.
In the UK, 95% of tests are positive after 4 weeks and 99% are positive after 6 weeks.
So in the UK where HIV cases are relatively low, a negative result at 6 weeks is good enough.
If you still worry about being in the 1% then check again at 12 weeks. People don’t test later than 24 weeks in the UK. In practice, a positive result after 24 weeks is because someone who has had sex again.
HIV is a very difficult virus to catch but even a small risk makes people anxious and worried, so having an early negative results lets people relax and go back to their normal life again. Please try to accept that negative tests at all these points, especially after 6 weeks, are good and okay.
Hello! I’m the one who asked all these trivia questions and wanted help because I had all the symptoms from fever to lymphadenopathy after taking pep, not while taking pep.
I just want when I can test myself with certainty and can trust the test.
Second, for some reason, the post-PEP testing window is shortened when follow-up studies still show people seroconverting after 24 weeks or even longer than that.
Or is the window period different from person to person and cannot be determined? Is pep indefinite? I just want to know how long I have to wait.