Anonymous
First of all, I want apologize for my bad English.
I had a sexual risk exposure. Within 4-8 hours later, I started taking ATRIPLA for PEP. A week later, I had another sexual risk exposure, but lower, so I took PEP for one more week aprox (I was taking ATRIPLA for 5 weeks, not 4). I couldn’t return to the clinic but I was very anxious, so I gave blood 45-47 days after finishing PEP for get an 4th generation test, and I gave blood 4-5 months after finishing PEP (I know it was wrong, irresponsible and dangerous, but I was so scared and no one supported me). It was negative. I re-test 1 year after PEP, it was negative too. I continue nervous, because I’m afraid 5 weeks of ATRIPLA and loss of a significant amount of blood can produce a false negative, even a year after PEP.
1. Can I consider conclusive the 4th test made 45 days after PEP?
2. It’s possible that a single or any infected cells remains in my body but in state of proviral latency (resting cells)?
3. It’s possible that these restings cells produce some infective virions, but they (virions or productively infected cells) can be lost with the blood I donated?
4. Can I be negative 1 year after PEP and become positive in a future for this incident?
Please, answer me because I’m really ansioux and depressed by this since more of a year. Thank you so much.
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Anonymous
Hi there, and thanks a lot for your question to the AIDS Vancouver Helpline.

It's great you decided to seek out medical attention after the encounter you were concerned about. It sounds like you're anxious about the accuracy of some HIV tests you've had after completing a PEP regimen, and after giving blood. We'll provide some information here that will hopefully help you feel better.

PEP prevents a potential HIV infection from establishing itself, so when thinking about it in terms of testing, extends the window period. As you said you took PEP for 4 weeks after that second potential exposure. This means that HIV tests are not considered conclusive until 12 weeks after you stopped the PEP regimen. It sounds like you've had a few tests after stopping PEP (about 45 days later, 4-5 months later, and 1 year later). If you hadn't had any other potential exposures between those tests, the tests at 4-5 months and 1 year are considered conclusive. We've mentioned PEP simply extends the window period, but drawing blood multiple times has no effect on testing accuracy.

The tests are very sensitive to HIV in the blood. We mentioned your tests at 4-5 months and 1 year are conclusive, and they are capable of identifying the presence of the virus whether it is latent, or actively producing new virus. You will not become positive in the future from this incident.

We would encourage you to check out our [risk assessment chart ](http://helpline.aidsvancouver.org/question/risk-assessment-chart) to determine the likelihood transmission occurred in the encounter you are concerned about, and for your future reference.

Thanks a lot for your question to the AIDS Vancouver Helpline. We hope this information has helped ease your concerns.

Trevor

AIDS Vancouver Helpline/Online

Monday-Friday 9am-5pm (PST)

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