Hiv When to Get Tested Again
When to test for HIV during and subsequently completion of PEP
I get this question a lot.
First of all, information on this is lacking and very difficult to come past.
There are many theories that hypothesize that PEP reduces viral replication and delays sero-conversion and therefore brand HIV testing less accurate. These theories accept neither been proven nor debunked.
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Furthermore, there is very limited data on the employ of P24 antigen tests (including Philharmonic/Duo tests) and viral load testing for diagnostic purposes in patient who have or undergoing PEP. In fact, studies on monkeys (and more limited studies on humans) accept shown positive viral load tests in individuals who were subsequently found not to be infected. This could represent an aborted infection (which is what PEP is supposed to and designed to do) rather than a truthful imitation positive. This illustrates one of the limitations of using viral load tests to diagnose people currently on or have completed PEP.
Official Guidelines
The U.s.a. CDC Guidelines on Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Utilize, or Other Nonoccupational Exposure to HIV in the United states recommends that patients should be tested for the presence of HIV antibodies at baseline, 4 – 6 weeks, 3 months and 6 months mail service exposure.
The Joint WHO/ILO guidelines on post-exposure prophylaxis (PEP) to prevent HIV infection recommends HIV testing at baseline, immediately afterward completing PEP (i.e. four to 6 weeks post exposure) and again 'iii – 6 months post exposure'.
The two guidelines are rather similar although the Us CDC seems to exist more firm on the requirement of a test at 6 months compared to the WHO guidelines.
Very recently, the New York State Department of Wellness AIDS Establish's adult HIV guidelines committee undertook a comprehensive re-evaluation of its HIV occupational PEP guidelines and issued some changes which included shortening of the time of HIV testing after exposure to 3 months if mod, blood based, standard HIV testing is performed. This is certainly promising all the same it refers to occupational HIV exposure only and the same data and recommendation may not exist extended to not-occupational exposure.
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Summary
In brusque, near official guidelines all the same recommend testing at 6 months for patients who accept undergone PEP.
Sometimes testing at 3 months mail exposure is good plenty merely this really depends on what kind of exam is done.
My own feel is the examination washed at 4 weeks exposure (or immediately upon completion of the PEP medications) is very indicative. I will however recommend a retest at iii months although I have nevertheless to come across the test at 4 weeks go it wrong.
At the cease of the day, the best person to propose you lot is still the doctor who prescribed y'all the PEP. He/She volition be most familiar with the sensitivity of local tests bachelor and the local guidelines.
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