[Question #1298] HIV window period and also blood draw risk from butterfly needle

49 months ago
Dear doctor hunter & hook . I hope both of you &your families are in the best of Health . I have meaning to write to doctor hunter first and then to dr hook if get permission to do so . I will just explain my scenario as I have zero Guidance .        
I am young man 27years of age Pakistan Single .made a mistake of having sex with csw (status unknown ) almost 9weeks ago . Lasted for 10seconds with condom on pulled out of guilt . But I got paranoid after a few days that maybe my condom broke . 
At 5 week ,6& 7 week HIV architect modular ci4100 hiv1/2 ag/abs combo from abbot diagnostics 
Result was negative 
I asked about p24 antigen they said it's a combined test and does not distinguish between HIV 1&2 however they told me I was tested for p24 in these tests 
They did a test through a butterfly needle at week 5 using a butterfly needle I didn't see the needle (kept my eyes closed )and used a vaccutauiner . I then got paranoid that maybe blood draw could even give me HIV . So I went at week 9 which is today and result was negative . 
I know this maybe surprising to you but I made a mistake of going to doctors who have no clue of what they were talking about . They told me to wait 12 weeks and even 6months 

My question 1 is my combo test conclusive at 28days? 
Question 2: can butterfly needles be reused  Even accIdently for blood draw can I get HIV ? it was through a vaccuitner . I do not want to question clinic integrity was just concerened because of human error  
So please explain risk of HIV blood draw if butterfly needle used accidently or if they are impossible to reuse 
Question 3: why is 12 weeks written on other CDC guidelines 
Question 4: given the model number did I have 4th generation test and am truely HIV free at 28days? 
I thank you both . I am writing these questions because I am inexperienced , alone a bit scared  and have never acted this  in my life . 
I thank you for your patience and I wish I could have spoken to you before as I heard you have retired . on health tap . 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
Welcome to the forum and thanks for your question.

Some questions can be answered confidently based only on the title. Before read your actual question:  The time to conclusive HIV test results is 4 weeks for the antigen-antibody combination tests ("4th generation"), 6-8 weeks for most other blood tests (3rd generation antibody tests), and 3 months for the oral fluids test. An RNA test is nearly 100% by about 2 weeks. Nobody ever catches HIV from having blood drawn; nobody reuses needles for blood drawing.

Now I have read your entire question. You were very seriously over tested and you needn't be at all worried about needle re-use or other HIV risk from having blood drawn. Also, most CSWs don't have HIV; and you had a condom protected exposure. Broken condoms are very obvious -- you wouldn't have missed it. Your risk was low enough that you really didn't need HIV testing at all. That pretty much covers it, but to be explicit:

1) Question 1: Yes, conclusive.

2) I suppose butterfly needles could be re-used. Unlike Vacutainer needles, they usually don't have built-in devices to prevent it. But nobody would re-use needles anyway; and a used butterfly needle would have very obvious blood visible.

3) Many agencies, including CDC, take hyper-conservative stances on time to conclusive results. It's just an issue of legal conservatism, unrelated to the latest science.

4) I don't understand "model number". The combo tests are 4th generation.

So all is well. You don't have HIV and don't need any further testing. Let me know if anything isn't clear.

HHH, MD

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49 months ago
Dear doctor hunter thank you for replying back to me , all of this re assuring . I went to clinic today and they showed me the whole withdrawal process they told me they are imported from usa , packed sterile and then discarded in a box which uses a cutter . They  even brought the person who did the blood test for me at 5weeks . 

  I have mixed my exposures unfortunately with condom intercourse done 9weeks ago and blood withdrawal risk a month ago (5weeks after condom intercourse) at clinic which I tested negative  yesterday(28days) 

However for argument sake  I took the test at 9weeks . Which is 28days from 5weeks . Even if I had HIV blood injected into me . 
1The test should ag/ab test should be conclusive at 28days any chance of false negative test ?

2 is there any other offical guideline which says ag/ab test at 28days ? Can I have a link or recommendation ? 

3this was blood withdrawal even if the needle could be contaminated the blood is going out and and I'm not being injected ? So blood withdrawal  is no risk at all ? Urban myth ? 
Has anybody been infected with blood withdrawal if not why what do statistics say? 

4) anyone turned positive after having  test at 28days HIV ag/ab at 12weeks? 

I will be honest with you I was planning to take test at 12 weeks (Nov)and then one in December for the  blood withdrawal to complete 12weeks for that exposure .

Please advice further I am looking upto you as a father and then a doctor . As I am planning to get married and don't want to be a risk to anyone 



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
1) As I said, the Ag/Ab tests become positive no later than 28 days. Once positive, they remain positive for life. In other words, a test at 9 weeks is just as reliable as one at 4 weeks.

2) Several agencies and experts use the 28 day period. The scientific evidence is unequivocal.

3) For sure "blood withdrawal is no risk at all". How could there be a risk when it's only your own blood?

4) This is the strongest evidence:  There has never been a proved report of someone with negative Ag/Ab test result at 4 weeks who later had a positive test or turned out to have HIV. It doesn't ahppen.

Feel free to be tested whenever and as often as you like. It's your money. Assuming no new exposure between now and then, it will be negative.

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49 months ago
Dear doctor your response has really made things as clear as they can get . I know this is my last message to you . 

So one last question
This abbot diagnostics ag/ab combo test is fully automated ? What I meant to say is  doctor told me that they are automated and don't worry they give the results very effectively . Like they are the same all over the world ? . Do they need skilled labour or the machine does everything ?

In short I was just making sure if I'm tested for antigens and antibody that was said in report also . So no mistakes can be made then ?  . It said state of the art usa abbot diagnostics ag/ab combo hiv1/2 ci4100 

So please let me know if this is fully automated or fool proof or requires a lot of skilled labour or can mistakes be made 

In the end I thank you for giving me such incredible response I wish all the best to you and your family may god always be with you .and I hope you never retire  it was a dream talking to you thanks again 


 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
The automation is the same everywhere and the procedures are pretty much foolproof. Time to stop worrying and move on!

That completes the two follow-up comments and followups included with each question and so ends this thread. Take care and stay safe!

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