HIV 4th Gen test after 43 days

[liucixin]

Hello,

I had unprotected insertive vaginal sex with a sex worker 46 days ago. I took PEP (Mylan Avonza TDF+3TC+EFV) 20 hours later and never missed a dose in 28 days.

At day 29th, I tested for HBV, Syphilis (TPPA) and HIV Combi PT.
At day 38th and 43th, I went for a retest with HIV Combo Ag/Ab.
All the results were Negative.

I would be most grateful if you would response to some of my questions:
1. Were my results for HBV and Syphilis at day 29th considered conclusive?
2. Have you ever experienced any case in which HIV Negative result turned Positive after 6 weeks with PEP?
3. Could you please briefly name some kinds of factors that contribute to the delay of HIV seroconversion?
4. I have had no sign of Genital Warts at this point. Am I considered safe with it?

Thank you!
Sorry for my bad English.

[Jim Allen]

Hiya,

Look sorry this happened, the good news is PEP is highly effective when started within 72 hours.

I suspect if this was your only exposure and you finished the course of medication correctly you will be fine, however,  test to confirm this. Test with a blood-drawn HIV antibodies test 6 weeks post-finishing PEP for a result, this result will rarely ever change and if you wish you can test at 3 months post-finishing PEP for a conclusive result.

1)

This is a HIV forum so all ill be willing to say regarding Hepatitis B is you should check with your doctor and get vaccinated, regarding testing guidelines on Hep B & C or if you had a risk you could ask the Hepatitis forum.
https://forums.hepmag.com/

Regarding Syphilis last time I checked the testing window was concerned 6 weeks and 3 months, so similar to that of HIV

2) Yes, PEP is highly effective but not a guarantee hence the need to test, although, it's so effective that you should consider testing as just confirming your negative status vs stressing about a possible reactive result.

3) PEP, Dying, Chemotherapy, Long term IV Drug usage. The only one that applies and is a real-world concern is PEP, and I've given you the testing guidelines for that situation. The others don't apply and/or even if they did it would still be extremely rare to delay the tests to the point it's not worth discussing.

4) No, and it's an odd question. Only a few strains of HPV cause visible symptoms like warts and those that do cause warts between a few weeks to several months post-infection, although, sometimes this can take longer. 

You should talk to your doctor about being vaccinated against the most common HPV strains


Here's what you need to know in order to avoid HIV infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider starting PrEP as an additional layer of HIV protection going forward

Keep in mind that some sexual practices which may be described as ‘safe’ in terms of HIV transmission might still pose a risk for transmission of other STI's, so please do get fully tested regularly and at least yearly for all STI's including but not limited to HIV and test more frequently if unprotected 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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