Welcome to our Forum.  I'll be glad to comment.  I reviewed the 8 year old paper that you provided a link to.   The paper, published in a journal which is not widely read, studied immune cells (lymphocytes and macrophages) from women with HIV and showed that on some occasions that manipulation of the experimental system with drugs that had a mode of action similar to the mode of action of antidepressants, there was reduced HIV activity.  In many of the experiments while there appeared to be small changes they were not statistically significant.   Unlike the drugs used to treat HIV, including those used for PEP and PrEP, the mechanism of action was NOT directly on the virus but was indirect, effecting white blood cells and the effect was not nearly so effective as the anti-HIV drugs.  Since this article was published, there have been no further publications supporting the theory set forth in the paper and among those of us who treat persons with and at risk for HIV there is no information the antidepressant medications significantly change HIV seroconversion or impact that natural history of the infection.  

If PEP fails it can still slow seroconversion because of the direct anti-viral effect of the drugs which reduce the rate at which the virus multiplies, thereby reducing the amount of virus present and providing less virus for the immune system to react to.  

I tend to discount any suggestion at present that anti-depressant therapy would meaningfully change HIV seroconversion.  It is not a substitute for PEP among at risk persons.  I hope this comment is helpful.  EWH

My only concern is that, according to the study, there could be an effect on the antigen production, therefore delaying seroconversion. If what the article presents is true, does it mean it affects antigen production, and thereby delaying seroconversion? 

I’m worried that the PEP and antidepressants could have similar effect—because both decrease the multiplication of the virus. 

So do the results of the article mean there will be a slower production of antigens and thereby delaying seroconversion—affecting my 4th generation test.

Thanks so much 

You have not described your exposure or the reason that you appear to have taken PEP so I have no context to provide you with a specific response to your situation.  In clinical practice however, I can assure you that if antidepressants had a meaningful and important impact o the efficacy of PEP, we would know it.

Again, as I read the article, the primary effect of the drugs which mimicked antidepressants in the test tube experiments made the point that they warranted further study- none of which have been done to my knowledge.  In my opinion, there is no reason to worry that your PEP might have been less effective because you are on antidepressants.  If you choose to honor this older, unconfirmed single article, that is, of course, up to you and you could test further.  Personally, I would not worry.   EWH

I’m not taking PEP.  I’m taking antidepressants.

It’s because I know that PEP delays seroconversion, and now after reading the article,  I concluded that if they have the same effects (decreasing hiv) then that would mean the antidepressants would delay seroconversion. 

My main question is this: according to the results of the study, will there be any effects on the production of antigens? If no, please explain why sit. If yes, is it significant enough to delay seroconversion? 

Thanks again sir!

as per Forum guidelines which permit three responses, these will be my final responses.

Sorry for the typo and my typing PEP rather than antidepressants.  My comments were directed at the unproven potential impact of antidepressant medications on risk for HIV seroconversion following exposure to an infected partner.  Let me be as direct as I can.  

1.  You state that you "know" that PEP delays seroconversion. This is an oversimplification.  PEP delays seroconversion because it keeps the virus from reproducing.  Once the drug is gone, seroconversion occurs at the normal pace.  The idea that PEP otherwise delays HIV seroconversion is not conclusive and does not occur in the majority of persons who take unsuccessful PEP.

2.  The journal you sited is not a highly read journal.  If the data were stronger from a scientific point of view, the results of the studies would have been published in a more widely read journal.

3.  The study is 8 years old, there are no follow-up articles verifying the observations in the study.

4.  The study used blood cells from persons with HIV and did not describe an effect on actual patients

5..  The study indicated and proposed that the effect of chemicals mimicking antidepressant effect worked through effect on white blood cells NOT on the virus(i.e. the "antigens") itself.  PEP works directly on the virus.

6.  The statistical analysis of the study results were not consistently significant.

Thus, my evaluation of this single, unconfirmed 8-year old article is that there is no compelling reason to think that antidepressant therapy would delay HIV seroconversion.

I hope my message is clear.  I see no reason for concern that a person taking antidepressant medications would require longer to develop a reactive HIV test following infection than persons not taking antidepressants.

This will conclude this response.  I hope my assessment is helpful to you.  There will be no further responses and the thread will be closed later today.  EWH