Dr. Bob, Please Help Me Get On With My Life
Apr 17, 2008
I live in Canada. I had an incident where the blood of another person came in contact with a mucous membrane in a health care setting. Though I was told the risk was small, I was put on PEP for 4 weeks. There was a bit of a delay (2 days) before I started as PEP is rarely given here and it took time to get the go ahead from the "powers that be" given the risk. Because I was still within the 72 hours I ultimately went ahead with it. I didn't miss any pills and in actuality the side effects weren't as bad as I expected. In any event, since the day of the incident I have taken 3 antibody tests (the only tests available in Canada) at 5.5 weeks, 8.5 weeks and 11 weeks. I spoke with an organization in Canada that provides HIV information, the National HIV information Line in Toronto, and also the HIV Line in Massachusetts and the GMHC in New York. All have stated that irrespective of the PEP, a 12 week test should be accurate and that 12 weeks in the VERY outside limit for testing (in fact the Massachusetts line said that they feel 6 weeks is an accurate test). However, I am still worried as the internet seems to suggest re-testing at 6 months. I know my 11 week test was a week short of the 12 week guideline. It will be 12 weeks in 2 days and I was planning to go back for another test then. Please help. I really want to put this behind me.
Response from Dr. Frascino
I'm appalled it took two additional days once it was decided you should be started on PEP. PEP efficacy is related to how quickly it's started! Therefore starting immediately is best; minutes are better than hours; and hours are better than days! The post-PEP testing guidelines recommend follow-up HIV-antibody tests at three and six months. You can download a copy of the guidelines at www.cdc.gov/mmwr/PDF/rr/rr5402.pdf . That your risk was minimal, you took PEP and you've tested repeatedly HIV negative out to 11 weeks post-PEP is extremely encouraging. The odds you did not contract the virus are now astronomically in your favor. However, I would suggest you remind the "powers that be" that a two-day delay for starting PEP due to administrative nonsense is unacceptable and dangerous. Send them a copy of the guidelines!
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