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Drs. please help!!!

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  • Drs. please help!!!

    Dear Dr.,

    I had two exposures in the same week, only four days away.
    I was on Triumeq PEP(not Truvada PrEP) at 40 hours after the second exposure, but I didn't complete the full 28-day course. I took 7 Triumeq in six days (I took it TWICE on the third day with 12 hours away to adjust medication timing, so it’s a 6-day-7-pill course, not 6-day-6-pill nor 7-day-7-pill.)

    1. Research shows PEP would prolong window period and could delay seroconversion if it failed
    ( for example,https://www.liebertpub.com/doi/full/....5319.abstract, https://www.ncbi.nlm.nih.gov/pubmed/25369451)
    I am wondering how long is the window period for my case where PEP is not completed? since I can’t find the answer to that of incomplete PEP course in any guidelines.

    2. If I was infected, would the 6-day-7-pill Triumeq PEP delay my HIV specific antibody response?

    3. I took Triumeq TWICE (12 hours away) on the third day of the course and the drug concentration would be high than if it was taken once daily. Will the fact affect the validity of test results at 19 months after the 6-day-7-pill Triumeq PEP course?

    4. Research shows that early treatment of ART in HIV infected patients may long effectively suppress viral replication even after the treatment stopped (https://www.ncbi.nlm.nih.gov/pubmed/20549847) and could blunt patients' HIV-specific antibody response and thus lead to long-term non-reactive or false negative testing results (http://ibase.info/htb/32657. http://programme.ias2017.org/Abstract/Abstract/1246)
    I am wondering whether the research findings could apply to my case, and wondering whether my testing results are possibly affected by 6-day-7-pill Triumeq PEP course and become false negative?

    5. I haven’t had other exposures since then. The HIV ag/ab combo test came back negative at 574(19 months) days after the 6-day-7-pill Triumeq PEP and RT PCR was target not detected at 488 days and HCV was negative at 559 days. Could the 6-day-7-pill Triumeq PEP affect the validity and reliability of the test results after the medication? Am I infected with HIV or HCV?

    Dear Dr., I regret a lot over the fact that I stopped PEP early and I have no idea how to confirm my HIV status. Please kindly answer my questions. Thank you very much !

  • #2
    You have had a negative HIV Combo test as well as a negative PCR test more than 1.5 years after the event
    I honestly don't think any Doctor will question these test results
    Stop worrying
    HIV Window Period: When it comes to HIV testing, two of the most common questions we have are “When Can I Test for HIV?” and “Are My Results Conclusive?”

    Comment


    • #3
      Dear Dr. Tan or other Drs.,

      Thank you for the response.

      My concern lies on the fact that I did not complete the full 28-day PEP course. What I took was a 6-day-7-pill Triumeq PEP.


      In your response above, you said, "I honestly don't think any Doctor will question these test results Stop worrying"

      What does that exactly mean?

      1. Is 1.5 years long enough for me to confirm my HIV status given 6-day-7-pill Triumeq medication may blunt HIV-specific
      antibody responses and prolong the window period?

      2 Am I HIV uninfected ? Should I have further testing? If yes, when do you think I can have conclusive and definitive test results?


      Dear Drs,
      Please kindly response. Please, help. Thank you very much !!!
      Last edited by Shun; 05-07-2019, 12:19 PM.

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      • #4
        Yes, 1.5 years is long enough for any test you have done to be thoroughly conclusive, regardless of the PEP you took.
        You do not have HIV. Your results are conclusive.

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