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4 weeks s/p exposure, undetectable viral load
Aug 26, 2009

Dr. Frascino,

I'm a health care provider, and I was stuck by a contaminated needle 5 weeks ago. To complicate things, I've had a runny nose/cough since 2 weeks prior to the stick.

I got a sore throat 2 weeks later, and I went to the ED. They diagnosed me with post nasal drip. They didn't think it was acute retroviral syndrome.

My sore throat/runny nose gradually improved, but then last week, I developed tender anterior cervical lymphadenopathy, had low grade fevers, and had 3 episodes of night sweats.

I went back to the ED and got a viral load checked, exactly 4 weeks s/p exposure. Today, I got my results, and to my surprise it was "<75, Negative for HIV." The reference range for this particular test was 75 - 500,000.

My question is how confident can I be that "I'm in the clear" from this test result? Do I still need to get my 6 week antibody test next week?

Yesterday I got what looks like viral conjunctivitis in one of my eyes, and since that's generally not part of ARS, I'm confident that I have something else going on.. like adenovirus infection

Thank you for your time!

Response from Dr. Frascino

Hello,

As a health care provider who was stuck by a contaminated needle, why didn't you report and document the occupational exposure when it happened? All health care facilities have policies and procedures in place to quickly evaluate occupational exposures and treat them with post-exposure prophylaxis (PEP) if necessary. The evaluation would also include HIV testing at the appropriate intervals when indicated. The recommendations for a significant exposure are for HIV-antibody testing immediately and at six weeks, three months and six months after the exposure. The quantitative HIV plasma PCR RNA viral load test that you had performed is not recommended for routine HIV screening.

You can download a copy of the updated guidelines for evaluation and management of occupational exposures at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm.

Good luck.

Dr. Bob



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