Hi, I had protected sex with a person of unknown

Posted on Mon, 11 Feb 2019

Question: Hi, I had protected sex with a person of unknown HIV/STD status - Oral and Vaginal, in Hong Kong. The condom did NOT break (as far as I recall), nor did I have any kissing/mouth contact with her sex organs, nor did she perform any act on me without condom. After I returned back I was afraid of contracting any STDs. I went to see a doctor, and he suggested I take up PEP medication just as a precaution. I did the full 30 day PEP course. At day 40 post exposure I did my STD profile testing - Negative for all STDs (Non-HIV), and for HIV there were 3 tests - HIV RNA PCR (Target Not Detected), P24+Antibody 4th Generation Duo test (Non-Reactive), and ELISA - HIV 1,2 (Non-Reactive). I was wondering how conclusive is this...what are my chances of being HIV free.. also given I was on PEP medication, I have heard this can impact results... please advise... I have no symptoms of any sort so far...(day 51 as of writing this)..

Answered by Dr. S. Murugan (2 hours later)

Brief Answer:
You are free from HIV Infection.

Detailed Answer:
Hi,.
Welcome to HCM.
Thanks for posting your query.
You had protected intercourse. No other risky sexual activities. Spouses of people living with HIV have regular protected exposures and remain HIV free for years together.
So there is no risk of HIV transmission in your case. Moreover you had completed PEP. That once again gave extra protection even if there is a remote possibility of HIV infection.
Your HIV tests (both Non-reactive HIV PCR and 4th generation HIV Combo test) also ruled out HIV 1 infection and negative STD panel 40 days after the exposure ruled out the possibility of STD. So you are free from HIV Infection and STDs. You can forget the incident and resume your normal routine. Nothing to worry.
Dr S Murugan

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. S. Murugan (33 minutes later)

Thanks Doctor... I also wanted to know how does PEP impact the Window period for testing...does it delay Sero conversion ? My tests were at 40 days post exposure and 9 days after PEP ended, so is it sufficient time for the effect, if any, of PEP on the results to be neutralized?..... also, I had asked for Western Blot test to be done when I gave my sample... but for some reason the labs has asked for a resample... what could be the reason... hope its not because they detected somthing which other 3 tests didnt...

Answered by Dr. S. Murugan (7 hours later)

Brief Answer:
Your chance of getting HIV/STD infection is almost"nil"

Detailed Answer:
Hi,
Welcome back.
If you had started PEP within 72 hours after the exposure, the infection, if any, would have been aborted. When anybody started PEP and not have completed, then there is a possibility of infection or failure of PEP, in which case we can expect a delay in sero-conversion. But you had completed the course as instructed by your physician. Then there is no question of delay of sero conversion.
You had not mentioned what drug you took as PEP and how much time after the exposure.
Indeterminate results are common with Western blot, so it could be repeated.
But in your case you had protected exposure. So not to worry about these rare and odd things.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. S. Murugan (13 hours later)

Thanks doctor... I started PEP around 64 hours post exposure... I was given Durart(Darunavir-400,Ritonavir-50) -2 capsules in morning....and Ricovir (Tenofovir Dispoxil fumarate - 300 and Emtricitabine 200mg) -1 tablet at night...full 30 days course was taken...and some antioxidants, an antibiotic for STD, support for side effects like ubsafe,mansam,samq10.... I was taking around 6-7 tablets every morning and evening.... hope this medication was enough...and my negative test results at 40 days post exposure or 9 days post pep ending should be a good sign....

Answered by Dr. S. Murugan (10 hours later)

Brief Answer:
Your PEP regimen is good and effective.

Detailed Answer:
Hi,
Welcome back.
PEP regimen is very good. There is no chance for HIV infection for you.
No more test is necessary.
Dr S Murugan

Above answer was peer-reviewed by : Dr. Yogesh D