study on pep

[eintshtein]

hi there

id just like to know if there were any studies conducted as scientific or medical proof that proves that pep can delay seroconversion.iv read so many times on this website that testing up to 4 months after exposure because of pep is advised when iv  asked about 5 hiv specialized organizations and 3 doctors about this and all of them have said that 3 months testing after exposure regardless of whether pep was taken or not is sufficient enough.so i would just like to know whether there are actual sources on this besides guidelines.

[RapidRod]

hi there

id just like to know if there were any studies conducted as scientific or medical proof that proves that pep can delay seroconversion.iv read so many times on this website that testing up to 4 months after exposure because of pep is advised when iv  asked about 5 hiv specialized organizations and 3 doctors about this and all of them have said that 3 months testing after exposure regardless of whether pep was taken or not is sufficient enough.so i would just like to know whether there are actual sources on this besides guidelines.

You read on here that you can obtain your conclusive test result 3 months post your last dose of nPEP.

[eintshtein]

thats correct.i have read it on here.that is why id like to know where these sources are coming from.

[RapidRod]

Did you have a possible exposure?

[eintshtein]

yes i did.it was unprotected vaginal intercourse.i started pep at 48 hours after exposure and completed the 28 regimen.i had my 3 month test and would like to know the validity of why another test should be performed at 4 months.

[Jeff G]

The average time to seroconversion is 22 days. Most who are infected will test positive by 6 weeks. For various reasons a small number will take longer and that is why we follow the CDC recommendation to test at 3 months for a conclusive negative result.

We go by the CDC recommendation . PEP pushes the testing window period out to 6 weeks post pep and again at 3 months .

Here's what you need to know in order to avoid hiv infection:

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence.

Anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

[Ann]

ein,

We advise adding the month on PEP to the testing window because of how hiv and how PEP both work.

PEP works exactly the same as it does in a confirmed positive person. It stops the virus replicating during various times in its life-cycle. When a person has very recently been infected and PEP is initiated within three days (72 hours), the virus can be stopped in its tracks, before it gains access to the various reservoirs in the body where it can hide from the meds. The fact that hiv hides in reservoirs is one of the reasons why a cure for hiv is so elusive.

The theory is that if hiv gets into the reservoirs before PEP is initiated, once PEP is stopped it can come out of hiding and start replicating in the blood again, because the meds are no longer in the blood. This means the process of antibody production starts within a week or so, when there is enough virus in the blood to trigger this response from the body's immune system. That's why we count the window period from the last day of PEP.

The biggest question mark over this process is that we don't know for sure whether or not hiv that may be hiding in the body's reservoirs can trigger antibody production. I'm not sure if we'll ever be able to answer this question.

I can't cite any sources and link to them because I was given this information face-to-face by my hiv doctor, whose brain I pick on a regular basis about these things. He's a well respected hiv clinician and pharmacologist who has overseen and written more hiv med studies than you've probably had hot dinners. 

You were never likely to end up hiv positive following a one-off insertive incident, but you do need to have that final three month post-PEP test result for a conclusive negative.

Ann