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DUDE
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Expert
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Reged: 06/13/00
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Posts: 114
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Don't like posting this stuff-but I found it
#6165 - 06/24/00 11:05 PM
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HIV Seroconversion in HCWs (Health Care Workers)
Data on the timing and clinical characteristics of seroconversion in HIV-exposed HCWs are
limited by the infrequency of infection following occupational exposure, variations in
postexposure testing intervals, and differences over time in the sensitivity of HIV-antibody testing
methods. Among the HCWs with documented seroconversions reported to CDC for whom
data are available, 81% experienced a syndrome compatible with primary HIV infection a
median of 25 days after exposure (CDC, unpublished data, 1998). In a recent analysis of 51
seroconversions in HCWs, the estimated median interval from exposure to seroconversion was
46 days (mean: 65 days); an estimated 95% seroconverted within 6 months after the exposure
(34). These data suggest that the time course of HIV seroconversion in HCWs is similar to that
in other persons who have acquired HIV through nonoccupational modes of transmission (35).
Three instances of delayed HIV seroconversion occurring in HCWs have been reported; in
these instances, the HCWs tested negative for HIV antibodies greater than 6 months
postexposure but were seropositive within 12 months after the exposure (36,37; J.L.
Gerberding, San Francisco General Hospital, unpublished data, May 1997). DNA sequencing
confirmed the source of infection in one instance. Two of the delayed seroconversions were
associated with simultaneous exposure to hepatitis C virus (HCV) (37; J.L. Gerberding, San
Francisco General Hospital, unpublished data, May 1997). In one case, co-infection was
associated with a rapidly fatal HCV disease course (37); however, it is not known whether
HCV directly influences the risk for or course of HIV infection or is a marker for other
exposure-related factors.
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Now you understand why I am not happy with a 6 month result,
but I was told at the time that a 6 months result was
conclusive.
These people are playing with fire.
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3 months is conclusive, not 6 months. But you have to understand it as the health departments tell you so. They say 3 months is conclusive until other clinical studies suggest another testing. You cant tell people to test at 12 months or at 24 months just because 2 or 3 people per year happens to seroconvert at this stage. It is also good to not have only a test but talk to an specialist, he would tell you if another test is needed, but for most most of the people 3 months is enough. LISTEN: NOTHING WILL EVER BE 100% sure. Nothing, not even a test at 2 years or 3 years. You will never get a 100% result. But they are not playing with fire by telling people 3 months or 6 months. YOU ARE PLAYING WITH FIRE with your STUBBORN attitude towars your liver here, your liver that. YOU WONT GET AN ANSWER ABOUT YOUR LIVER HERE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
TAKE ANOTHER TEST (YET ANOTHER ONE) AND TALK TO YOUR DOCTOR, HE WILL TELL YOU: YOU ARE RIGHT, MOVE ON.
So do that and THEN "MR. LIVER", PLEASE: GET A LIFE !
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I thought about various ways to respond to this.
I don't know why you think that there are only 2-3 seroconversions missed per year, given that there probably over a million seroconversions a year, and the test itself is only 99.7% accurate at best (i.e. after everyone has started producing antibodies).
The studies that have been done can only tell us that 3 months is around 95-99% accurate; this is because of the small numbers of people used in them. The 3 month test could be 95% accurate, or it could be 99% accurate. I would take the lowe bound, for safety's sake.
Similarly, we have an example of only 94% accuracy at 6 months, and suggestions based on this that 12 months may be a better testing period. It may be that this is for HCWs only because of PEP.
In the general population, I have not seen studies large enough to allow any estimate of accuracy as high as 99%. Saying that 6 months is 99.9999% accurate is ludicrous, given the 99.7% sensitivity of the antibody test in known +ve patients.
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By the way, I am sorry for being a pessimist, but that is the way I am. Risks that I cannot control get to me.
I cycle in heavy traffic, and I have cycled at speeds that could be fatal if there was a mechanical failure. I have had a racing tricycle on two wheels on a corner! I have driven a sports car around a formula 1 circuit, and I have often been karting, which can be dangerous. None of these scare me, I find them all exhilirating. I am not so brave when it comes to disease, though!
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Mr liver, you said that you are scared when it comes to desease, then why do you continue to take sexual risks.. didn't you mention also that you had risky encounters again. You mentioned this when describing the acuracy of your last test.... What's up w/ that?..
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No, not sexual risks.
Being attacked by thugs outside a nightclub, along with your friends, is a risk - if someone punches you in the face, hard enough to fracture your cheekbone, then there can be blood-blood contact (I did bleed from just below my eye). I got off lightly, one of my friends lost 70% of the sight in his right eye from a kick to the face.
Playing contact sports such as soccer might be considered a risk.
Both of these are very low risks, but they are not zero. The soccer risk is multiplied by the fact that I play about three times a week, when I am not feeling too run down.
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zazoo
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Regular
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Reged: 06/13/00
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Posts: 36
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You really worry too much. Relax and enjoy life for God's sake. Life is too short to keep on worrying about red eyes. Do a biopsy for your liver and if it is fine, just forget about it. I did tests for HEP B,C and autoimmune and all came back negative eventhough I had elevated liver enzymes and painful URQ for over 4 months. I completely do not believe that I am infected with HEP C or B. They do not usually incubate for more than 6 months. You will have antibody for Hep c before Hep B. The symptoms of Hep C can take more than 20 years to show up but antibodies take less than 6 months for sure. I have been to a gastrointoritus and he actually told me all this. It is from thefrom the horese's mouth.
Let your hair down and enjoy life, believe me it is a good idea.
All the best Bad liver.
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Mr. Liver, you are indeed obsessive. But so am I. I have been obsessed off and on about AIDS for the past 15 years. Can you imagine that? 15 years? Well it wasn't exactly 15 continuous, fear stricken years, but it was periods of months of terror/depression periodically over 15 years. Do you want to be like this?
I was a single, hot-blooded male and I liked to have sex every once in awhile like all men do. Every time I did, I would obsess about AIDS, sometimes for months, until enough tests would relive me, or some other more serious worry would occupy my mind.
I never did get the disease ,though sometimes I wish I had, because "not knowing" and "worrying" about every possibility was worse then actually getting the damn thing. At lease when you get it, you can stop worrying about it.
Now I am married and I still obsess about AIDS. Sixteen months ago, before I even met my wife, I messed around a lot with girls and I guess now I fear it will come back to haunt me (even though I have been tested so many times over the last few months).
The point is, "it never ends". Your fear, paranoia etc about this disease will probably never end. This is a disease with a "moral" component to it, "stigma", "rejection", long, miserable therapy, long, slow death...you name it, it is the worst possible disease that has afflicted mankind. Its even worse than Ebola virus. At least with Ebola, you die in 1 week after exposure. With AIDS, you don't know for months/years if you have it and then when you find out you live for decades not knowing when you will die. It also does not have any "hero" component to it (like Cancer does or Lou Gerigh's disease has), hence most people simply cannot accept any possiblity or chance of having this disease.
I am considering writing a book about my experience with AIDS fear. If anything, people can use me as a research study. You and others can take some comfort in the following experience.
Over 15 years, I have had sex with many women prostitutes. Never did I get HIV.
Every time I used a condom, sometimes the condom broke. Still no HIV.
I have had sex with women all over the world:
Canada, US, Thailand, Philippines, Middle East.
Never did I get HIV.
I have had girlfriends (who were not saints) and regularly had unprotected sex with them. Never did they give me HIV.
I have had tests in the mid 80's, late 80's, early 90's, mid 90's, year2000. Never did I get false positive or false negative results.
I have had tests all over the world too. Never a positive result.
To hell with the Health Care Workers study, you have a 15 year study of me.
Conclusion:
1. it is very difficult to acquire this disease
2. HIV tests are extremely accurate.
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Zazoo, thanks for your support; the problem with this liver situation is that it is a disease which is often silent or only produces non-specific symptoms. Plus, as I am not an alcoholic, simply someone who used to enjoy too much beer when out with friends, which means that the liver tests that I have had cannot tell me anything.
In acoholic cirrhosis, the liver function tests are often normal within a week of abstinence!
Given that I appear healthy from the outside, and my LFTs and ultrasound are normal, then my doctor would never allow a biopsy, as a biopsy can have serious complications, including death in rare cases.
I am considering seeking a second opinion.
There is nothing more for me to discuss here.
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