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Is My result encouraging at 28days with these Test?
Nov 15, 2010

I am based in South Africa.

I had a sexual exposure on the 8th October 2010 and after 2 weeks on the 22nd October, I found out that the girl was HIV positive, I told a doctor who said it was late for PEP but he was still placing me on the PEP. I started PEP 23rd October. On the 25th I had 4th generation test that is negative. On the 1st Nov 2010 I had a HIV PCR test that was negative.

Kindly advise me of my chances of having HIV? I took the 4th generation test again on Friday 5th November 2010 which will be 28days after the exposure and result were also Negative. are my results encouraging for further negatives? I have tested at 28days and the result was Negative that was last week friday the 5th November. I would test again next week 14days after that should be the 19th Nov 6weeks from exposure, am just stressed and so so depressed. But I strongly trust in God. I am sure from 28days am encouraging.I have actually had a cough and some sore in my mouth but the doctor says that could be stress and anxiety etcare sypmtons true signs? Please advise with your expertise.

Response from Dr. Frascino

Hello,

Your physician was correct when he advised you it was "late for PEP." Too bad he didn't follow his own advice. PEP is most effective if begun as soon as possible after an HIV exposure. If more than 72 hours have lapsed, PEP is not longer warranted and really has no chance of helping. I would advise you discontinue it immediately.

Your physician's second error is ordering an HIV PCR viral load test while you were on PEP (antiretrovirals) in an attempt to diagnose HIV disease. This makes no sense whatsoever. If you were HIV infected as a consequence of your exposure, the antiretrovirals in your PEP regimen could drive your HIV RNA PCR viral load to undetectable levels. If you then use this as a test to diagnose whereto you are HIV infected, you could get an undetectable result and wrongly assume you are HIV negative (false-negative test).

As for HIV-acquisition risk, it would depend on the type of sexual exposure (oral, vaginal, anal) and whether it was latex-condom protected. Other factors would also come into play, such as viral load, viral strain, concurrent STDs, host immune integrity, etc. The bottom line is that if you've placed yourself at risk for HIV, you need to be HIV tested. An HIV-antibody test taken outside the window period remains the gold standard. You can read much more about HIV-diagnostic testing and related issues in the archives of this forum.

Good luck.

Dr. Bob



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