FYI: Does PEP lead to delayed seroconversion in HIV-infected individuals?

[strata]

Members,

There's been some interest and debate here on the effects on PEP on seroconversion in patients who seroconvert, so I did some research. Here's what I've found:

The general consensus is that PEP does not, except in rare circumstances, impact the time to seroconversion.

Links/Excerpts:

http://www.dhs.ca.gov/aids/Resources/pdf/pepguidelinesfinal.pdf

A case of delayed seroconversion in a treated monkey suggests that delayed seroconversion may occur in the context of human PEP, although this has not been reported in either the occupational or non-occupational setting except during co-transmission with hepatitis C [4, 11, 29].

http://www.thebody.com/cdc/pep/pep06.html

Three instances of delayed HIV seroconversion occurring in HCWs have been reported; in these instances, the HCWs tested negative for HIV antibodies >6 months postexposure but were seropositive within 12 months after the exposure. Two of the delayed seroconversions were associated with simultaneous exposure to hepatitis C virus (HCV).

Related:

http://italia.medscape.com/viewarticle/513928

There are currently 6 worldwide case reports of HIV seroconversion despite combination HIV PEP. (2003 study)

http://www.hivinsite.org/InSite?page=pr-rr-07-01-05

[Effectiveness of nPEP]

[lexman]

that is one more reason to use the PCR tests in combination with the EIA, and ELISA.

And that is what scares me about the regular antibody tests. I really think that a combination of p24 antigen test, PCR DNA and RNA with EIA or ELISA is the way HIV testing should be done these days. To remove even remote slightest possibility of detection error and mental strain on a patient.

[wackybong]

hi lex, how's your oral trush? any improvement? oral trush is a common disease and anyone can have it, what medication are you taking for the trush?