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When should I get tested if...
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When should I get tested if...

I've taken Post-Exposure Prophylaxis. Since it's been said that PEP can delay seroconversion, should I wait until 3-months after exposure or 3-months after my PEP was completed?

Thank You
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Avatar_m_tn
13 weeks after your last dose of medication.
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Avatar_n_tn
Thank you!

Quick question. Since many people say that a test 4-6 weeks after exposure is conclusive, is that not true for PEP takers? (4-6 weeks after last PEP med taken)
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Avatar_m_tn
No and the reason being is to see if the PEP medication has stopped the virus replication and NO antibodies have started to develop. You have to realize that PEP is no guarantee that you won't become HIV infected. It works about 85%-87% of time. It takes longer on the testing period on persons that have taken antiviral drugs.
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Avatar_n_tn
Thanks. I guess I'll have to tough it out until mid-April. I've got every single symptom but hopefully that's all the result of stress. I don't know how I'm going to make it to April though!!

Thanks again.

One last q: PCR tests also delay PEP detection, how long would I have to wait to take a PCR? If I absolutely needed to for peace of mine that is...
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Avatar_m_tn
There is not a peace of mind test for anyone that has been on PEP. You need an antibody test and that is what you are waiting on. What was the reason you were given PEP to begin with?
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Avatar_n_tn
Actually most doctors say PEP will not effect antibody production for obvious reasons. PEP lowers the viral load in your blood. If the smallest amount of the virus is present in your body, you will produce antibodies. A little research would tell you that too. A regular antibody test 6 or more weeks after exposure should be pretty conclusive. Although I would still test at 13 weeks.
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Avatar_m_tn
What was the risk that you needed to take PEP for in the first place?
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Avatar_m_tn
The use of PEP before 72 hours is to prevent kill the virus before it goes in the seroconverison stage, that is from Neg-Pos. PEP is prescribe to stop the replication to the stage before the body ever need to build the antibody production. If one would have antibodies to HIV then they are infact HIV positive.  
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Avatar_n_tn
You are exactly right. PEP is an attempt to stop the virus in it's tracks and get it out of your system.

So if PEP has not killed off the virus in 4 weeks then antibodies would be produced by then. Therefore making a test 6 weeks after exposure still just as accurate as someone who is not on PEP. If PEP is ineffective then the virus would have been in your body the entire time you were on PEP, allowing your body to produce antibodies.
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Avatar_m_tn
No, that is incorrect thinging again. PEP, taken within 72 hours, if it doesn't eliminate the virus slows the progression of antibodies , that makes it take longer for the body to make antibodies to build up enough to even test. It takes from on average 22 days for the body to serocovert without the use of PEP. PEP is taken for 4 weeks, 28 days. So your thiking that the body will have by then produced enough antibodies to test in incorrect. PEP causes the body to take longer to produce antibodies.

  
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Avatar_n_tn
I've read some of the threads on PEP and seroconversion on aidsmeds.com. The consensus over there seems to be that PEP DOES delay seroconversion.

Dr HHH here and Dr Bob on thebody.com seem to think that PEP would have little effect on time to seroconversion.

My own limited research has found the following:

1) Delayed seroconversion has been observed in one monkey in a study of the effectiveness of PEP.
2) Instances of delayed seroconversion have been observed with HCWs who were prescribed PEP for occupational exposure, but delayed seroconversion occurred only with those co-infected HCV.

So, I've concluded that the recommendations for testing through 6 months have been mainly because scientists cannot say conclusively that PEP does NOT delay seroconversion based on the few studies that have been done.

You and many others on aidsmeds.com, however, seem much more adamant that PEP definitely DOES delay seroconversion. Can you share some references that have led you and others to this conclusion? I'm curious to expand my knowledge.
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Avatar_m_tn
I'll get the information to you asap.
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Avatar_n_tn
txtony,

Thanks for checking in on me. Like most of us, I vascillate between rational calm and abject terror. I'm still very early in the window following a receptive oral exposure (no ejac) to a man who admitted to being HIV+ mid-coitus. I took 3-drug PEP for 28 days and adhered to the regimen religiously. I had 'baseline' tests (PCR/RNA and ELISA) at the hospital ID clinic at 2.5 weeks; both came back negative. I have a follow-up appointment next Wed (~6 week mark). But the waiting is killer, and I'm spending too much time reading about HIV and not enough time completing actual work.
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Avatar_n_tn
hey man, how are you doing, i know we are all going through that moment in our lives where it seems that the carpet is pulled from under us. stay strong, you guys have been my lifeline,even before i had posted here.

teak: thanks for giving info to us straight. i admire your courage and strength.

remeber, oral sex is extremely low risk, doc hhh says very  very low. i know, i feel like that too at times, even when people tell im neg. i know i am, but sometimes hard to believe. im oraying for you brother.
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Avatar_f_tn
I've been on pep after an exposure sexually but am worried coz i started somehow late at 60hrs and the lady was conmfirmed reactive, is there any possibility of failure?.
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Avatar_m_tn
PEP is around 85% effective.
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