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Are there rapid PCR, P24 antigen, viral culture or other rapid tests for suspicious needle sticks?The Body: Rick Sowadsky M.S.P.H., C.D.S, Answers to Safe Sex Questions

Dec 29, 1996

Are there any rapid tests available for supicious needle sticks or used in medical centers' neonatal units?

Response from Mr. Sowadsky

Hi. Thank you for your question.

Tests like the Qualitative PCR tests, p-24 antigen tests, viral culture tests etc. are NOT used for routine testing, nor for follow-up on needlestick injuries. As I have discussed in previous questions, these tests are designed for very specific purposes, and unusual circumstances. The antibody tests are used for follow-up on occupational exposures (including needlesticks) to HIV. The chance of infection from a known HIV positive person through a needlestick injury is 0.3%.

For testing of newborns less than 18 months of age, Qualitative PCR tests are used, since antibody tests are not reliable in newborns. This is because in babies of HIV positive mothers, the mothers antibodies gets into the baby during pregnancy, and the baby can therefore test positive, even if the child is not infected. By 18 months of age, the maternal antibodies will no longer be in the child, and antibody tests can be used. When PCR tests are done in newborns, they are either done more than once, or in conjunction with other diagnostic tests for HIV. Therefore, when we test children less than 18 months of age (from known HIV positive mothers), the non-antibody tests are used.

If you were to get a needlestick injury, it is critically important that you do the following:

1) Give yourself the necessary first aid, and report the exposure immediately!

2) If the patient is KNOWN to be HIV positive, when AZT, 3TC, and a protease inhibitor (in combination) are begun within 2 hours post-exposure, they can reduce (but not eliminate) the chance of you becoming infected. These medications are given after a KNOWN, significant exposure, but not for low risk exposures (such as just getting blood on intact skin), or for suspected exposures. Specific guidelines have been written by the Centers For Disease Control (CDC) regarding what treatments to give, and when, during occupational exposures to known HIV positive patients. I have these guidelines available for you if you want them. These treatments are not designed to be used for suspected sexual or other non-occupational exposures.

3) Do a baseline HIV antibody test at the time of exposure. This is used to rule out previous (non-occupational) infections.

4) Repeat the HIV antibody tests at 6 weeks, 3 months, and 6 months. Testing beyond 6 months is not necessary. During this 6 month period, the exposed healthcare worker must assume that they've been infected, and use condoms during sexual activity, and not donate blood/organs, nor share needles with anyone (just in case they were infected).

I hope this answered your questions. If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).

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