HIV Prevention and Testing > Am I Infected?

Post PEP Testing

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odysseus:
Hello,

I've been a dedicated reader over the past weeks, and have learned more about HIV and other STD's here than I did at my 'blue ribbon school of excellence' high school.

My situation (I'm a male): 10 weeks ago I drank way too much one night in HK, and ended up going home with sex worker who was originally from Thailand (not sure if that affects anything in anyway, but, just thought i'd add it).  I received unprotected oral, had protected vaginal, and tried to have protected insertive anal (my first time).  However, during anal, the condom broke - twice.  Both times I noticed immediately (thanks to the loud 'pop' sound), and withdrew w/in 5 seconds.  I put on a new condom both times and continued until done.  The two times from breakage to w/drawl would be my exposure.  I did not notice any blood on the last condom used.

Sobered up about 10 hours later and realized I made a mistake.  Returned to the states the next day, contacted an HIV specialist, and was prescribed PEP (combivir/viread).  Began PEP at hour 48, and completed the PEP w/ 100% adherence. 

One month post exposure I tested negative for the standard set of std's, hiv included, however I had an irritated meatus (tests were done at a lab, not w/ a doctor and physical examination).  8 weeks post exposure (4weeks post-pep) tested negative for HIV I/II. 
Today is 10 weeks.  I still have an irritated meatus (slightly inflamed for parts of the day, though no pain/burning), and will see a urologist tomorrow.  If anyone has any info regarding irritated meatus's, I'd be very appreciative if you could share it.

But, my main question is: what are the chances, with the risk described and the 8week negative ELISA I/II antibody test, of converting to positive?  When will I have a conclusive result: Would a 3 month test be conclusive, or b/c I took PEP do I have to wait 6 months for a conclusive antibody test?  6 months post-exposure or post-PEP?  Would a PCR test give me a conclusive answer if I was to take one today?  Yes - I'm hoping to put this experience behind me as quickly as possible, though plan to always keep it in mind.

The first 6 weeks were pretty awful for me, as I was completely consumed with fear/anxiety/guilt/etc.  The past four weeks have been dramatically better, until this evening, when I returned to checking out 'the websites' and reading about late seroconversions and co-infections affecting results and HIV II not being detectable and and and...(albeit, this info was usually from a not so knowledgable poster writing about something they read 'somewhere on the internet') .

I'm grateful for any info anyone can provide, and please let me know if anything needs clarification.

A sincere thank you,

O

ps: the spell check function attached can use some work.

et in arcadia ego:
Hi,

According to what I was told by a professor of pharmacology at the conclusion of my PEP, a PCR would be an excellent indicator of status for you at this point. A conclusive Elisa result can be had 13 weeks after the conclusion of PEP.


best,
mike

Ann:
Odysseus,

I can't see your negative results changing because your risk was only slight. You were protected up until the condoms broke and as you knew both times exactly when they broke, your potential exposure was only a matter of seconds. Hiv is a fragile, difficult virus to transmit, and even more so to the insertive partner. To be honest, PEP was not really warranted in your case.

The fact that you heard a popping sound when the condoms broke leads me to believe that you were probably not making sure there was no air in the condom. This is one of the leading causes of condom breakage. It is also very important that you use plenty of water-based lube when engaging in anal intercourse.

Please read through the condom and lube links in my signature line so you can make sure you are using those condoms correctly in future and avoid this kind of thing happening. Correctly used condoms rarely break.

I would NOT recommend that you have a PCR test done. These tests have a high rate of false positives and for this reason, they are not approved for diagnostic purposes.

Test again, using an ELISA antibody test, at 12-13 weeks after the date of your last PEP dose. This result will be conclusive and I'm fully expecting you to receive a negative result.

Ann

odysseus:
Thanks for both your replies.

According to the doc who prescribed my PEP, a negative ELISA 3months post-exposure is conclusive.  I have read a few times on this board that the window period begins when PEP ends, and hence the conclusive test comes not 3months post expsoure, but 3 months post-pep.  However, I have not come across any other evidence/literature supporting/citing the 3months post-pep idea.  The Body's Dr. Bob says that PEP would not delay seroconversion, so I do not understand why seroconversion and the conclusive testing date would be delayed a month.  The CDC website suggests testing at baseline, 6 weeks post-exposure, 12weeks post exposure, and then 6 months post exposure - but nothing about 4 months post exposure ( 3months post-pep). 

So, where does the 3months post-pep = conclusive idea come from?  And is 2months post pep/ 3months post-exposure not conclusive?

Thanks...

o

Matty the Damned:

--- Quote from: odysseus on June 13, 2006, 10:05:55 PM ---Thanks for both your replies.

According to the doc who prescribed my PEP, a negative ELISA 3months post-exposure is conclusive.  I have read a few times on this board that the window period begins when PEP ends, and hence the conclusive test comes not 3months post expsoure, but 3 months post-pep.  However, I have not come across any other evidence/literature supporting/citing the 3months post-pep idea.  The Body's Dr. Bob says that PEP would not delay seroconversion, so I do not understand why seroconversion and the conclusive testing date would be delayed a month.  The CDC website suggests testing at baseline, 6 weeks post-exposure, 12weeks post exposure, and then 6 months post exposure - but nothing about 4 months post exposure ( 3months post-pep). 

So, where does the 3months post-pep = conclusive idea come from?  And is 2months post pep/ 3months post-exposure not conclusive?

Thanks...

o

--- End quote ---

Odysseus,

I've also always understood that PEP extends the window period so that as Ann says you will have to test 12-13 weeks from the date of your last PEP dose. PEP consists of potent Anti-HIV drugs that supress the replication of the virus and thus can inhibit the production of HIV anti-bodies.

This sounds like something you should ask your doctor to clarify.

MtD

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