[Question #6646] When test after PEP ?

14 months ago
Drs. 

After a single exposure with a prostitute (condom broke), i took PEP  (36 hours later), but i developed symptons like: sore throat, mouth ulcers, inflamation of the gums and a single herpes in the lipe (all this when i took PEP).

After this, i tested:

a) 35, 43, 47, 53 and 59 days AFTER THE EXPOSURE with rapid test (3rd generation) - NEGATIVE;
b) 60, 69, 75, 84, 90, 130 days AFTER THE EXPOSURE with 4rd generation test - NEGATIVE;
c) 120 days AFTER THE EXPOSURE with PCR (40 copys) - non detectable - NON DETECTABLE

With 90 days i test for syphilis, hepatitis b and hepatitis c - all NEGATIVE.

So, this are my questions: 

1) Are these results conclusive?

2) Are the symptoms I had, especially gum inflammation, symptoms of HIV ? Symptoms of PEP ? or anxiet ? 

3) I read that, in some cases after using PEP, antibodies are only developed after 6 months. Does this happen in the 4th generation tests? 

4) Can I return to sex without a condom with my wife?

Sorry for my english, i'm from Brazil. 



Edward W. Hook M.D.
Edward W. Hook M.D.
14 months ago

Welcome to the Forum.  Thanks for your questions.  I happened to be on the Forum when your questions arrived so you are receiving a reply more rapidly than is often the case.  Responses to any follow-up questions may take longer.

Following an exposure to a partner known to be infected with HIV the risk for acquiring HIV is never higher than 1% and, depending on the type of exposure, may be considerably less.  PEP reduces the risk for acquiring infection even more and is thought to reduce the risk for HIV infection, even more- about 80% in many studies as long as it is started within 72 hours of the exposure.  The sooner PEP is started the more effective PEP is.  In your case I presume that you do not know whether your partner had HIV or not.  You can be sure that there is a more than 99% chance that you did NOT get HIV as a result of your broken condom.  With this background, I can assure you that your test results definitely prove that you did not get HIV from the exposure that you mention.  More detail:

1.  The value of most of your 3rd generation, antibody only tests is questionable.  Even without PEP these results would not be definitive until at least 8 weeks (56 days) after exposure and with PEP that period becomes longer.

2.  On the other hand, your 4th generation tests do prove that you were not infected.  For persons on PEP results are considered definitive 3 months (120 days) after the exposure and at 8 weeks following completion of PEP.  This your results from 90 days are highly suggestive and the results from 130 days are conclusive.

3.   Your 120 day results, particularly when considered with your other test results are also conclusive

Thus, in answer to your specific questions:

1) Are these results conclusive?
Yes, see above.

2) Are the symptoms I had, especially gum inflammation, symptoms of HIV ? Symptoms of PEP ? or anxiet ? 
These symptoms were not due to HIV and were coincidental.  Your anxiety may have made them more likely to occur.

3) I read that, in some cases after using PEP, antibodies are only developed after 6 months. Does this happen in the 4th generation tests? 
No, see comments above.

4) Can I return to sex without a condom with my wife?\
Yes.

I hope this information is helpful.  You can be confident you did not get HIV from the encounter you mention above.  EWH


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