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Frequent reader, worrier, sorry NY Jack-I gotta ask!
Feb 5, 2002

Okay Dr. Bob~

Ya'll are cofunsing me. I read and read again many of the questions/answers in a couple of forums and I am wondering what to think.

First, ya'll say that the Standard for HIV testing is 3-6 months. Then, I read responses from you, Dr. Holodny, and Dr. Little and ya'll say a test at 11 weeks to 12 weeks is as good as the 12 week...Mr. Kull does not agree.

Second, Mr. Sowadsky said HIV would only live minutes outside of the body because Labratory tests had to use extremely high and not naturally found concentrations of the virus in order to test it. So, with naturally occuring concentrations in cum or vaginal fluid-minutes would be max; but, you and Dr. Holodny say hours or after it dries. Now, ya'll do an excellent job here but for some of us the conflict is too much. (I am among those who tested just a few days "before" the window period of 12 weeks.) It took all I could gather in the courage department to go be tested the first time and now the CDC says my results are not reliable. Help me out here please, what are the chances of my 11 week test turning pos. at 6 months. Statistics/Odds? (I was taking Valtrex just a couple days before I tested-I don't know if that does anything to Viral load or antibody production.)

PS. I am really sorry for asking this but I can not be the only frequent reader wondering how ya'll got stabbed and cut-did the patient do this to you or was it a freak accident?

Response from Dr. Frascino

Hello -

First off, Valtrex will not affect diagnostic tests for HIV. Second, you are asking for concrete and extremely precise answers to questions that have way too many variables for any of us to give you the exact information you are searching for. 11+ weeks vs. 12 weeks, in my opinion, really doesn't make much difference at all, especially if you are testing for a low - or relatively low-risk exposure. If you had an exposure like mine - very high-risk - then yes I'd recommend testing out to 6 months. Statistics and odds ratios can only be calculated if we know all the variables. How long does HIV live outside the body? Best answer is not very long. Yes, it will depend on the fluid (blood vs. semen, etc.), the concentration of virus in that fluid (high vs. low viral load), the quantity of fluid (small drop of blood vs. a gushing artery), and many other conditions as well. So as you can see, we really can't give you an exact answer, such as 1 hour 36 minutes, and 13 1/2 seconds.

As for your P.S., you are wondering if one of my patients perhaps went wacko and stabbed me? OK, you've been watching way too many horror flicks lately. Time to turn off the Sci-Fi Channel. I was performing a medical procedure on a very kind gentleman with advanced-stage HIV, when an involuntary contraction of his leg caused the hollow-bore needle to lacerate and puncture my gloved hand. It was an unfortunate accident. If it had been a wacko patient attacking me with a bloody hypodermic needle, you would have seen me on Oprah (or at least Geraldo)!

Stay well,

Dr. Bob


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