Can 17 doses of PEP delay HIV detection in a 4th-gen test?

Hello doctor,

I tested negative for HIV (human immunodeficiency virus)-1 & 2 using a fourth-generation test on day 22, day 27, and day 35 after the first exposure. I was immediately placed on PEP (post-exposure prophylaxis), due to a second exposure which was after a month. I completed 17 doses of PEP and then discontinued it. My second contact partner was confirmed negative for HIV. I tested negative via a fourth-generation test on day 33 and day 60 post-PEP, which equates to 112 days post my first exposure.

My question is: Can 17 doses of PEP delay seroconversion if exposed, and not be detected on tests for HIV-1 or 2?

Please help.

Thank you.

Thank you for the reply doctor,

I tested negative on days 22, 27, and 35 after my first exposure. Immediately after the negative 35-day fourth-generation lab test, I started PEP for the second exposure. After the first exposure and negative tests, I experienced some initial symptoms. I continued with PEP for 17 days and discontinued it as my partner tested negative and was confirmed negative via lab testing. During PEP, I still experienced unexplainable symptoms, which was bothersome. However, after discontinuing PEP, I began feeling terrible about a week later and still do not feel like myself.

Please help.

Thank you for the reply doctor,

Could the 17 doses of PEP between the first exposure cause delayed seroconversion for HIV-1 or 2 antibodies? My last test was conducted 112 days after the first exposure, and I have not had any further exposure since then. I am concerned about symptoms experienced before, during, and after PEP. Could we discuss my symptoms further?

Hello,

Thank you for the reply doctor,

Is there sufficient time for seroconversion for HIV-1 & 2 antibodies even with 17 doses of PEP? Would PEP not suppress viral load or antibody response? In my area, HIV-2 is not very common according to medical practitioners, but it is still possible. Would a 4th generation test at 112 days, regardless of the 17 days of PEP, still detect antibodies for both HIV-2 and HIV-1?

Thank you for the reply doctor,

So I should calm down about all these unusual symptoms and not feeling well. I felt at my worst after PEP. Could it not be related to HIV at all? There are so many symptoms, though.

Thank you for the reply doctor,

I have been struggling with appetite loss and experiencing some other symptoms since I discontinued the 17 doses of PEP. Additionally, I had some strange symptoms both before and after PEP following the first exposure. I believe that by now if the symptoms were related to HIV, something would have appeared on the tests for HIV-1 or 2 antibodies.

Thank you for the reply doctor,

The symptoms are quite concerning, but as you said, the HIV tests are negative, so they could be due to something else.

Thank you for the reply doctor,

Just one last question: Will a late PEP during the acute phase have no effect on the development of HIV-1 or 2 antibodies if truly exposed during the first exposure?

Thank you for the reply doctor,

So I can relax regarding the possibility of HIV-1 or 2 antibodies and late seroconversion due to the 17 doses of PEP. I would still produce antibodies for both regardless of the 17 doses of PEP.

Thank you for answering my questions doctor.