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PEP and window period

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Cerevel:
Hello,
Itís my first post here. Firstly, thanks yo all the members/staff for supporting this forum.

Im 37 yo, male. I had unprotected vaginal sex with a girl I met one night (14th may). 56 hours later I started taking PEP (truvada + raltegravir) for 30 days.

I took 2 hiv tests from vein (antibody hiv1/2 + antigen p24) 6 and 8 weeks after last dose of Pep. Both of them came back negative.

In the forum, you always say that a negative test after 13 weeks after finishing Pep is conclusive, but checking CDC guideline about PEP (updated 2016, i rhink itís the last update document), I think it says that a negative test is conclusive after 3 months from exposure (not from finishing PEP). Itís on page 27 of 91 of the guideline that i attached.

Could you help me and explain please? Im a little anxious because os window period.

Thanks a lot.


Jim Allen:
Hiya,

There have always been two trains of thought on nPEP /oPEP and testing, given the evidence, we lean towards the conservative train of thought when given testing guidelines on the forum in combination with ART usage.

There are cases when PEP and also PrEP that is more widely used, fails causing delayed detection. Hence the rule of thumb, PEP is a 28-day testing delay so simply apply testing guidelines post-finishing PEP instead of post-exposure.

This means testing with a blood-draw HIV antibody test 6 weeks post-finishing PEP for a result, this result will rarely ever change. You have done this, and the results were non-reactive.

So I see no reason for further HIV testing over this potential exposure. However, you can if you wish.

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse correctly and consistently, with no exceptions. Consider talking to your healthcare provider about PrEP as an additional layer of protection against HIV

Keep in mind that some sexual practices described as safe in terms of acquiring HIV still pose a risk for other easier acquired STIs. So please do get tested at least yearly for STIs, including but not limited to HIV, and more frequently if condomless intercourse occurs.

Also, note that it is possible to have an STI and show no signs or symptoms, and the only way of knowing is by testing.

Kind regards

Jim

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2015:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4641668/
2017:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578893/
2016:
R.Harrington
https://depts.washington.edu/nwaetc/presentations/uploads/219/nonoccupational_hiv_post_exposure_prophylaxis_npep.pdf

PrEP:
https://www.aidsmap.com/news/may-2018/prep-may-make-it-hard-tell-if-someone-has-hiv-infection

Cerevel:
Hello again,

Finally, I decided to repeat hiv test (antigen p24 and anti hiv1/2) 13 weeks after last dose of PEP. The result came back negative again.

However, my general doctor told me to repeat again 6 months from exposure (Im from Spain-Europe).

what the doctor told me has made my anxiety rise again.

What do you think about it?. Im nervous.

Thanks a lot for your time.

Jim Allen:
6 months is 25 years outdated.

You didn't aquire HIV from the concerned incident, relax and move on with your life.

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