needle exposure

Question

I had a deep needle injury, patient had a high viral load, and was initiated with pep within 3 hours. Did have many symptoms during the first month, rash, weight loss, and oral mouth ulcers. 3 viral load rna pcr were done and all negative. My pep was extended to 6 weeks. Elisa at 12 weeks negative. My doctor stated that their were no conclusive studies on whether pep extended the window. He stated that they observed animal studies and drew conclusions based on that. He stated that studies show that the mean time health care workere convert is at 46 days, regardless of pep. He stated that 95 percent is likely at 3 month testing. Can you please commment.

Answer

Hi,

I'm not exactly sure what you'd like me to comment on. You had an occupational exposure and were started on PEP quickly (within three hours). Your three undetectable HIV quantitative PCR RNA viral load tests within the first month were encouraging. There really is no sound evidence for extending a course of PEP beyond 28 days. Your negative ELISA at 12 weeks is very encouraging. The post-PEP HIV-screening guidelines recommend follow-up HIV-antibody tests at six weeks, three months and six months from the date of exposure.

You can read more about occupational exposure, PEP and HIV testing in the archives of this forum.

Good luck,

Dr. Bob