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Sore throat, swollen glands, blocked nose and ears. Histroy of exposure of hiv+ blood on finger. Hiv tests negative. Further test required?

Hi Doc,

I had a low risk exposure to an hiv + persons blood on the skin of my index finger, the skin was intact as I had no visible cuts. There was only a small amount of blood. By the time I noticed the blood it had dried, this made me worry that I may have rubbed my eye or picked my nose in the time before noticing the blood and washing it off.

My doctor put me on combivir as P.E.P which I took for 30 days. After completing the medicine I started to get flulike symptoms sore throat, swollen glands and blocked nose and ears. Which passed in around 2 weeks.

I then had the hiv1 DNA pcr qualitative test 14 days after stopping the medicine, which came back negative. My doctor said this was conclusive and I needed no further testing. But I tested again using a rapid hiv1/2 finger prick test which was performed by a nurse 10 weeks after exposure. And then again at 11 weeks post exposure with another rapid elisa test where my doctor took blood from my arm. Both tests came back negative.

The whole testing process is confusing to me regarding the window period. I understand 3 months is the time where test may give wrong results. But have heard that pep makes that period even longer??

I would just like to know if my tests are conclusive or if I will need further tests? If so which tests would be recommended and when?

Thank you
Asked On : Sun, 21 Apr 2013
Answers:  1 Views:  101
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Question is related to
Diseases and Conditions
Lab Tests
Infectious Diseases Specialist 's  Response
Hi Marc,
I understand your concern regarding the tests for HIV as this dreadful disease has caused quite a scare. Thats why WHO has come up with very strict guidelines to avoid missing HIV positive cases.
However, as your query suggests that you have had a low risk exposure on your finger.
Ideally you should have washed the wound immediately and post exposure prophylaxis should be started within two hours of exposure.
There are many tests available for detection of HIV.
They can be grouped as rapid tests, supplemental tests and confirmatory tests.
As your doctor has suggested you have undergone HIV PCR which is a confirmatory test. The rapid tests help in screening as well as diagnosis.
Your doctor is right that as all the tests came negative, You do not have to worry much.
However, according to guidelines, HIV test is performed at 6 weeks, 12 weeks and 6 months post exposure, regardless of whether or not Post Exposure Prophylaxis was taken or not.
Please consult your doctor for the test to be done and confirmatory tests are preferred.
Answered: Sun, 21 Apr 2013
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