Odds???

Question

Following brief 5min unprotected sexual intercourse (im a male, with a female) in a high risk region (South Africa) i was put on nPEP for a month (Combivir), the following are my tests and results after i finished the course:

1month (3rd gen) Elisa post exposure after pep - negative
3 months post exposure PCR - negative
4 months post exposure another Elisa - negative
5 months post exposure another Elisa negative 

With so many different guidelines on testing window period, i would like to know if the above results are conclusive. I will still test in 3weeks time at 6months post exposure, however what are the chances of seroconvertion form now to then? Does this late seroconvertion after pep ever happen? Have you ever seen it happen?

All my std tests for hep c,a,b 5 months post exposure are negative, other stds also negativ and i do not inject drugs nor do i think i have a very weak immune system, therefore that cannot effect delayed seroconvertion can it?. 

I have not engaged in any behavior to put me at risk since however my anxiety and depression is getting very bad!!

One more thing, i got the girl to test 3 weeks post our insedence with 4th gen duo and it came back negative however it may be possible she is in the window period still??

Thank you for your time look forward to your earliest reply!!!!
ANT3.

Teak · Answer

We are not responsible for incorrect information you get from other websites.

tomMulligan · Answer

"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.*******.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).

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]" - by strata

ant3 · Answer

Has anyone got any evidence other than me taking your word for it that the wondow period post npep is now 3months after the last dose of pep and not the 6months post exposure if pep has been taken?

Any links or journals i can look at? 

With so much contradiction on the internet about post pep window period its very difficult to believe everything you read???

The body, still suggests testing to 6months if one has taken pep??

tomMulligan · Answer

Thanks for that input Teak. I'll take full consideration of that comment.

Teak · Answer

Wrong answer. nPep does delay the window period. Their test will be conclusive 3 months post the last does on nPEP.

tomMulligan · Answer

*Dont let your self get into anxiety as it will cause you more problem and will be really hard to deal with

tomMulligan · Answer

Look, your test result at 3 months is conclusive. PERIOD. Pep has nothing to do with the your neg result at 3 months. In short, pep cannot delay or afects your HIV screenings/ result beyond window period. Again, only People on chemo, those that are taking antirejections drugs for organ transplants and chronic IV drug abuses will develop seroconvertion. You must trust your result and rest it assured that you didn't get HIV from that incident. Do let your self get into anxiety as it will cause you more problem and will be really hard to deal with.

RainLover71 · Answer

your window period starts from the time you have taken your last dose of nPEP.So your 5 months has covered that period well and truly.Stop worrying because your results are conclusive.

ant3 · Answer

Can pep not delay (lengthen) seroconvertion time? or is that time still within the 5months iv tested? How accurate is the pcr test after two months after pep treatment given that the pep might have driving hiv to undetectable levels?.....how long would it take for hiv to replicate and become detectable on these tests?

tomMulligan · Answer

People on chemo, those that are taking antirejections drugs for organ transplants and chronic IV drug abuses are the candidates for seroconversation and not those on npep. YOur test results are conclusive. You don't need to take any further tests for HIV.

ant3 · Answer

When you say the window period of 3months has passed, do you refer to my case even though i have ben on pep? i have heard the window period is 6months post exposure when you have taken pep? is this outdated or no longer necessary?

RainLover71 · Answer

Your 100% conclusively hiv negative and there is no need for stress and anxiety.You have tested well passed the hiv window period of 3 months and all tests were negative.Your safe.

tomMulligan · Answer

Your test result is indeed satisfying and GOLDEN conclusive. its as clear as a snow that your results outweigh the thoughts that you got HIV from that incident.  People on chemo, those that are taking antirejections drugs for organ transplants and chronic IV drug abuses are the candidates for seroconversation and not through taking npep. Many people will have detectable antibodies in three or four weeks and very really few in 9-12 weeks. Think about this, Your neg diagnostic test result at 3months plus your upcoming 6months test results will also be neg. would you believe it? Would it make you feel less worry?.