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If you're on PrEP to prevent HIV infection, the CDC recommends having an HIV PCR test at every PrEP visit with your physician.1

After an HIV infection, it takes your body 23 to 90 days to produce enough antibodies and antigens to be detected by a standard blood test after an exposure.2 For individuals on PrEP, this detection period can extend to an average of 126 days, and up to 600 days, for a serology test to show a positive result.3

Due to this delay, the CDC now mandates that, as of December 2021, an HIV PCR test must be performed alongside a serology test at every PrEP visit.1 PCR tests can detect a breakthrough HIV infection much sooner than serology tests.2 According to a recent study, unfortunately, the implementation of CDC PrEP guidelines across the nation varies significantly, thereby restricting our patients' access to the necessary care.4

If a breakthrough infection occurs, it's crucial to discontinue PrEP and start HIV therapy immediately to prevent treatment resistance and ensure the best long-term outcomes.5 Delayed detection and treatment can lead to resistance to first-line HIV therapies, resulting in significantly worse outcomes for patients.1, 6

Find a location to obtain an HIV PCR test:

References

  1. Preexposure Prophylaxis for the Prevention of HIV Infection in the United States - 2021 Update Clinical Practice Guideline. Accessed Aug 26, 2024 ; REF-35585

  2. https://www.hiv.gov/hiv-basics/hiv-testing/learn-about-hiv-testing/hiv-testing-overview Accessed Aug 26, 2024 ; REF-43717

  3. Analysis of False-negative RAPID Tests Performed on Oral Fluid in 3 International Clinical Research Studies. 2017. CID 64(12): 1663-9. Accessed Aug 26, 2024 ; REF-09609

  4. High Rates of Missed HIV Testing Among Oral PrEP Users in the United States From 2018-2021: A National Assessment on Compliance With HIV Testing Recommendations of the CDC PrEP Guidelines. Open Forum Infect Dis. 2024 May 23;11(5):ofae254. doi: 10.1093/ofid/ofae254. PMID: 38798900; Accessed Aug 26, 2024 ; REF-43721

  5. Breakthrough Acute HIV Infections among Pre-Exposure Prophylaxis Users with High Adherence: A Narrative Review. Viruses. 2024 Jun 12;16(6):951. doi: 10.3390/v16060951. PMID: 38932243 ; Accessed Aug 26, 2024 ; REF-43718

  6. From Innovation to Implementation: The Evolution of HIV Pre-Exposure Prophylaxis and Future Implications. Pathogens. 2023 Jul 9;12(7):924. doi: 10.3390/pathogens12070924. PMID: 37513771; Accessed Aug 26, 2024 ; REF-41893