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When is it safe to stop testing after pep can I move on
Aug 13, 2013

Hi Dr. Wohl

I had an exposure to blood on my skin. I think my skin was intact but am concerned about a possible mucous membrane exposure. I was put on combivir as pep which i took for 30 days and completed. I have since tested negative for the following:

14 days after stopping pep negative hiv DNA pcr qualitative test 12 weeks post exposure negative insti rapid hiv test 24 weeks post exposure negative hcv and hbv antibody test 24 weeks post exposure negative insti rapid hiv test

Are the insti rapid tests accurate enough for me to stop testing now and move on with confidence in my negative status or should I do a 4th generation elisa test?

Is there a need to test after 24 weeks or 6 months post exposure?

Thank you kindly for any help you may be able to provide me with, your opinion is greatly valued.

Response from Dr. Wohl

Most experts would not recommend PEP following blood exposure to visibly intact skin as this is considered a very low to no risk exposure. New recommendations regarding occupational exposure to HIV were just released last week by the US CDC and they have a bearing on your question. These have been long anticipated and state:

"Follow-up testing at a minimum should include the following:

HIV testing at baseline and at 6 weeks, 12 weeks, and 6 months after exposure; alternatively, if the clinician is certain that a fourth-generation combination HIV p24 antigenHIV antibody test is being utilized, then HIV testing could be performed at baseline, 6 weeks after exposure, and 4 months after exposure."

So, you are done with testing.

DW



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