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Antibody Tests affected by PEP

Mar 26, 2012

Back in 2003, Dr. Bob wrote that antibody production is not affected by PEP meds You can see it here:

Since then, has this information been changed? Everywhere I read, a 6 week antibody test (2 weeks after finishing PEP) is fairly irrelevant, because PEP meds do in fact keep viral levels low enough to prevent antibody production. This is why testing at 3 months (2 months after finishing PEP) and 6 months (5 months after finishing PEP) is recommended.

Should that page be modified ?

Response from Dr. Young

Hi and thanks for posting.

Wow, I would view a 2003 post as archival rather than gospel. That said, I agree with our departed friend, Dr. Bob.

The recommendations for HIV testing after PEP/nPEP haven't changed for years. They recommend antibody testing at 3 months (and 6 after high-risk exposure). I generally agree that a test at 6 weeks does only limited good, only to raise apprehension, since it's never going to be definitive (and as such a waste of emotion, time and money)- though it's not really because of the issue of PEP and antibody production.

Note that there are subtle differences between the US PEP guidelines (directed at occupational exposure) which states, "After baseline testing at the time of exposure, follow-up testing could be performed at 6 weeks, 12 weeks, and 6 months after exposure. Extended HIV follow-up (e.g., for 12 months) is recommended for HCP who become infected with HCV after exposure to a source coinfected with HIV and HCV." and nPEP guidelines, directed at non-occupational HIV exposures. The later recommends, "All patients seeking care after HIV exposure should be tested for the presence of HIV antibodies at baseline and at 4--6 weeks, 3 months, and 6 months after exposure to determine whether HIV infection has occurred. In addition, testing for sexually transmitted diseases, hepatitis B and C, and pregnancy should be offered."


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