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Does PEP Medication Extend HIV Testing Window?

Posted on Wed, 1 Oct 2014

Question: I had unprotected insertive anal sex with a partner whose status I don't know. The intercourse lasted for less than a minute. I read the risk for insertive partner is comparatively low (1 in 1666). I consulted a doctor who prescribed PEP. Will the PEP medication extend HIV testing window? My immediate HIV Elisa Test came as negative. Please help me.

Answered by Dr. Deepak Kishore Kaltari (21 minutes later)

Brief Answer:
PEP does not affect window period

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear Mr XXXXXXX

Unprotected anal sex with an individual of unknown status definitely warrants the need of PEP.
PEP does not affect the window period for HIV testing. The window period is of serological window period, it depends on time taken for body to form antibody against HIV virus. Do continue with the PEP.

Do get back to me if you need any further assistance, will be glad to assist you.

Take Care

Best Regards
Dr Deepak Kishore
MBBS,MS,MCh

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Deepak Kishore Kaltari (9 minutes later)

Sir, I know I am at risk, but is it that I will definitely get HIV? In addition, this internet searching and symptom chasing is making my life a hell. Please give me some reason not to lose hope

Answered by Dr. Deepak Kishore Kaltari (25 minutes later)

Brief Answer:
PEP will take care of it

Detailed Answer:
Hi

Do not worry or panic. I would also advise you to stop searching the internet for further explanation, internet is full of resources and overload of information may cause confusion and panic.
Always go with the advise of experts.

As you are already aware the risk of transmission is 1 in every 1600 to 2000. It means for every 2000 individuals having similar exposure only one person gets infected(This is without PEP: Infection rate of only 0.05%). PEP drastically reduces this rate further if initiated within 72 hours of exposure.
As you have already been put on PEP , do not be worried. It is highly unlikely for you to get HIV.

Do keep me updated about your health. Do not be worried.

Wishing you great health.

Best Regards
Dr Deepak

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Deepak Kishore Kaltari (20 hours later)

Thanks sir. Just one more question. From today afternoon, I started feeling mild pain in throat. It's in extremely upper part of the throat, and is confined to just one point (not in the entire throat, and it appears to be pain in bone), which gives mild pain if pressed. I also smoke, but not excessively. This is again scaring me. Please help me out.

Answered by Dr. Deepak Kishore Kaltari (2 hours later)

Brief Answer:
nothing to worry

Detailed Answer:
Dear XXXXXXX
The pain is not related to hiv infection.
I would suggest you warm saline/Betadaine mouth gargling which will relieve your symptoms.

Take Care

Regards
Deepak

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (4 days later)

I really thank you sir for all your support during this phase. But may be I need more help. I think I am too much into symptom chasing due to which even normal things are appearing scary. Recent being some little pain in my tongue (mouth ulcer?). No open wounds, its just that the tiny granular dots which are on the tongue appear to be reddish? What could this be now?

Another thing. I am planning to go for Elisa Antibody test at 4 weeks (after completing PEP). Is this a right decision, or should I wait for 6-8 weeks protocol period?

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer:
They are likely to be stress related

Detailed Answer:
Hi
Dear XXXXXXX

They are likely to be stress related. Multivitamin supplements, rest and good sleep will take care of the lesion.
I would recommend you to get HIV ELISA only after 8 weeks after exposure. PEP is given for 4 weeks, repeating ELISA at 4 weeks will not be helpful, as still its in serological window period.

Do write to me anytime for any further assistance.
Do not worry.
Have a stress free life

Regards
Dr Deepak

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Deepak Kishore Kaltari (27 minutes later)

Thanks sir. But I read that a four-week ELISA is at least 90 per cent accurate? Is it the case?

Answered by Dr. Deepak Kishore Kaltari (56 minutes later)

Brief Answer:
Elisa only after 8 weeks

Detailed Answer:
Dear Mr XXXXXXX

The serological window period is 80 to 90 days . Serological test which detects antibodies like elisa is unlikely to be positive before that period.
So would recommend you to follow the protocol of testing after 8 weeks of exposure.

Take care

Best regards
Dr T

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Deepak Kishore Kaltari (2 days later)

Sir, I read that HIV duo test (HIV 1/2 and P24) is very conclusive at four weeks. But is it that there is a risk of getting false positive result in this test as against the 3rd generation ELISA test? As you clearly understand my entire situation, would you suggest me to go for the duo test after 28 days?

Answered by Dr. Deepak Kishore Kaltari (9 hours later)

Brief Answer:
P24 can be done at 4 weeks

Detailed Answer:
Hi
Dear Mr XXXXXXX

P24 antigen assay and RT DNA PCR test( They detect antigens) are very specific and sensitive test.They become positive in infected individuals 7-10 days after exposure. You can do them at 4 weeks, negative test rules out HIV infection.
Serological test which detects antibodies like ELISA may be still negative at 4 weeks as antibodies would not have been formed at that time.

So you can go ahead with P24 antigen and RT DNA PCR test at 4 weeks.

Take Care

Best Regards
Dr Deepka

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar