[Question #13097] Info about transmission

2 months ago

Good morning,

I would need clarification with respect to the mode of transmission to understand whether an event may actually be at risk: I underwent a cosmetic mesotherapy treatment by a doctor.

He used several needles for the treatment (which consists of micro injections of homeopathic drugs, so with a read out of blood) and, honestly, I did not pay attention to whether all the micro needles (4mm approx.) were new and disposable.

In case the needles, even by accident, were reused by the previous patient (at least 5/10 minutes before) a risk exists?

I ask this question because 6 days after this treatment I started to have a slight fever that 20 days later does not pass but has become intermittent. I have done several tests (including ebv and cmv) but all negative, I only have ESR and lymphocytes a little high.

What do you recommend me to do? It has been almost 30 days. Could a 3rd generation self test be reliable already since I am presenting symptoms?

Thanks very much

2 months ago

Adding to my previous question: in case I’ll do the test, do you think there could be some cross reactions (since I still have symptoms) and the possibility of potential false positives?

H. Hunter Handsfield, MD

2 months ago

Welcome to our forum. Thank you for your question.

Stopping with a preliminary reply after reading the first line: Nobody in the world is believed to have acquired HIV during a cosmetic procedure. While in theory there may be risk in certain circumstances, a procedure by a physician (assuming you mean a medical doctor) is especially unlikely to be risky.

I see no reason to suspect the needles were not fresh ones, previously unused. I cannot imagine any physician in any country at this time in history re-using needles or other sharp objects without employing single-use disposable instruments; or on rare occasions, sterilizing them properly between different patients. And even if re-used, the risk probably would be minimal: a previous patient would have to be infected with HIV (or other blood borne infection) and the re-use would have to occur within hours or at most a day or two. By that time, air exposure and drying would have killed any virus present, especially in the small amounts that could be retained in micro needles.

HIV symptoms cannot start as soon as 6 days after exposure. Ten days is the earliest and HIV symptoms generally start after 10-20 days. Also "slight fever" is not, by itself, likely a symptom of HIV.

Finally, you do not list all the virus tests done except CMV and EBV (which like HIV would be little or no risk in this situation), but presumably also included HIV. However, your closing line suggests you have not yet been tested for HIV. For reassurance, you should do so now. It is not possible to have HIV symptoms and test negative with a third generation blood test, so a negative result would prove your symptoms are not due to HIV. But for a truly conclusive test result, have another third generation test at 8 weeks; or an antigen-antibody (AgAb, 4th generation) test at 6 weeks. You can expect another negative result.

Slightly elevated ESR and lymphocytes "a little high" do not sound alarming. As for "potential false positives", there are NO medical conditions that interfere with the HIV blood tests or alter their reliability.

All things considered, I am confident your minor ongoing symptoms have nothing to do with the cosmetic procedure; you have overreacted in all the testing you have done. I hope that testing at least was done with a doctor's guidance, i.e. you're not trying to manage your own testing.

A final thought is suggestion is that you contact the doctor who did the cosmetic treatment and ask about new versus re-used instruments. I am confident she will reassure you there was no risk of infection.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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2 months ago

Good morning, thank you very much for your reply.

As suggested, I did a rapid test (insti test, so I assume 3rd gen) at 29 days after the presumed risk.

I know it would not be conclusive, but based on what I told you and since I have been presenting symptoms for 20 days (intermittent fever, headache and sore throat that come and go), can I consider it reliable enough? Even if it is a rapid test, shouldn't it at least be questionable after almost 30 days of exposure and 20 days of symptoms? Or do you think it might change when I’ll repeat it? For the sake of completeness, I will tell you that earlier this month, so just before I started getting sick, I had done my usual full annual checkup that included hiv test (4th gen), which came back negative.

H. Hunter Handsfield, MD

2 months ago

The symptoms of HIV are caused by the immune system's reaction to the virus, not by HIV itself. It is not possible to have HIV symptoms and test negative. In other words, your negative test results mean that something other than HIV is the cause of your symptoms. The rapid tests are just as reliable in this regard as lab based tests. Your result will not change with any additional tests you have.---