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Window period and PEP
Jan 3, 2009

Thank you Dr. Frascino for answering my previous question regarding my first (and last) unprotected recpetive anal sex with ejaculation.

I took my trick to get tested one week later. Thank God he tested HIV-negative with OraSure.

I have 2 questions:

What are the chances or estimates that he was in the window period and will seroconvert after testing negative?

Why does the CDC recommend discontinuing PEP for occupational exposures if he tests HIV-negative, even though the window period is up to 6 months. Isn't that playing Russian roulette?

Thank you Dr. Frascino.

Response from Dr. Frascino

Hi,

1. Extremely remote.

2. No. In an occupational setting when the source patient tests HIV negative, the recommendation for the health care worker to discontinue PEP is based on risk-versus- benefit ratio of continuing the potent antiretroviral drugs for a full 28-day course. The risk of drug side effects and toxicities needs to be balanced against the estimated statistical risk that the health care worker really had a significant HIV exposure.

Dr. Bob



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