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health care exposure
Jun 2, 2006

Dear doctor, as a health care worker in Germany i was exposed to HIV while getting injured by a hole-needle just after having implanted it. Unfortunately it showed up, that the person (african woman with hepatic unclear tumor, fevering) was positiv not knowing it (virus load 48.000, probably no treatment). I took PEP starting 41 hours after exposure (Kaletra, Combivir) for almost 8 weeks and i finished now. Elisa-Testing at 36 and 55 days after exposure remained negative so far and no relevant clinical symptoms of acute HIV syndrom occured. I read a lot and i am very much worried. Appearingly a hole needle contact is associated with a higher risk or transmission and i started PEP relatively late. My questions: Is there a possibility that HIV detection by standard ELISA testing is delayed by PEP? Would it make sense to make a HIV-PCR in addition? As everybody who had was exposed to HIV, i am cant get it out of my mind and i would give a lot for having an answer soon. Thank you very much for your answer.

Response from Dr. Frascino

Hello,

In general I do not recommend PCR for routine HIV screening. I would suggest you follow the guidelines published by the U.S. Public Health Service. They can be assessed at the following Web address: http://www.thebody.com/cdc/pdfs/pep_guide.pdf.

These guidelines recommend ELISA testing at baseline, 6 weeks, 12 weeks and 6 months.

Your negative tests out to 55 days are very encouraging!

Good luck!

Dr. Bob



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