[Question #1827] Window period HIV . How early can combo test be taken

44 months ago
Dear doctor hunter 



I have small question currently . I have read ag/ab combo or duo is conclusive at 4 weeks 


My question is 

1) how early can one take a combo test even if it's not conclusive but for some assurance ? 

2) can a person take a combo test after 10days ?  How early can one take the test 

I just had a finger pric  test for sugar and let's just say I wasn't looking unfortunately.  The nurse was wearing gloves also and it was hollow pointed needle not a lancet  in which She had to pric myself . However I did examine her hands after that and I saw no blood on her hands or anything  .im sure she didn't pric herself but I'll ask about this concern with you in the next post just to clarify .

But would like to  know what is the earliest one can take a combo test ? since pcr is not available 
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Welcome to our Forum. Dr. Handsfield and I share the Forum and today I happened to pick up your question and will be answering it.  We have worked together for more than 30 years and never disagree on our assessments. 

The event you describe was a no risk event.  If you had asked me if you need testing, I would have said no, definitely not.  I'm not sure why a nurse would be using a hollow point needle to a finger stick but even so, there has never been a case of HIV transmitted under the circumstances you describe.  In answer to your questions however, a 4th generation, combination HIV antigen/antibody test might begin to detect HIV as soon as a week after exposure however as you mention, results would not be definitive until four weeks after the exposure.  It is difficult to predict what proportion of infections might be detected as early as 10 days.

You are worrying needlessly.  I hope this message will help you to move forward without concern.  EWH . 

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44 months ago
You are worrying needlessly and no one has been infected this was was the only main thing I read and has given some sort of relief 

Honesty is best policy . Google has played a role on this for my mind to think this way and I would like you to help me as I think listening to dr  hunter or you would be best 

Her pen was Flawaed and I opted to use the baby needle on me . It's for children mostly has known as winged needle it's very small usually to draw blood and has small tube attached 

For argument sake I will tell you my experience and then maybe you can just tell me forget about it or you can tell me to test  

Obviously you were not there but I'll try giving you the picture 

The needle was hollow packed and I took the cover of myself I told her to go slow but no she had to rush just a little to get me worried she wore gloves 

1)But It in an unlikely event she pricked herself through the latex glove would I have known?  

2) would blood have been exposed to air ? And deemed inactive on the needle  ? 

3) if she pricked herself and then proceeded to pric my finger with it would that be enough to put me at risk ? 

4) is finger pric enough to cause HIV or would I need huge amount of blood 

5)honestly I saw her hands after the test and they were super clean to no cuts or visible  blood to the naked eye . Is that good enough or small cut I missed to the naked eye could transmit HIV 


Question on hair cut

I have read that haircut could cause HIV .  if I go to a barber and he uses a scissor and let's say my barber is HIV positive and he cut his hand and got blood on the scissor . And he nicked me with a scissor on my neck can I get HIV ? .  Or would I need extreme deep wound which requires medical attention to put me at risk ?  . This is a general question I haven't had such an exposure but I am only asking 


Testing 

With all due respect why is 4weeks conclusive when Cdc says 3months .why are you alone. On this matter only doc hunter says 4weeks is conclusive 

Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

You need to stay off the internet.  It will often mislead and misinform you.  We have little patience with hypothetical. "what if" questions, particularly if they are repetitive as yours are.  Brief answers to your questions follow:

1.  Probably.  Please understand that health care professionals wear gloves to protect themselves from patients, not the other way around.  If her glove had failed she would have changed it.

2.  Infectious blood cam remain infectious within a hollow needle.  There is no reason for you to be concerned however as the needle was new and there was no evidence that anyone other than you was stuck with it.

3.  This is an unrealistic question.  Hypothetically yes, realistically no.

4.  HIV can be transmitted through injection of small amounts of infectious blood deep into tissue.

5.  Give up on this line of questioning.  There was no risk from anything you have described.  You need to move on. 

The idea that HIV is transmitted through barber shops is another internet-based, hypothetical myth.  This question has no relationship to your original question.  I have nothing more to say about this.

We have explained this multiple times.  The package inserts of newer tests use older tests as their standard for evaluation.  Research data however clearly show that at 4 weeks, combination, 4th generation HIV tests provide conclusive results.  Dr. Handsfield and I are not alone is this- this is widely accepted by experts.  The CDC and FDA have to be conservative in their advice and approach. 

Please, no more hypothetical or repetitive questions questions.  If you do, they will deleted and ignored.  EWH 

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44 months ago
I will stay of the Internet doc and I will read what you have said 

Basically with information I have provided 

Can I just simply state that infection has never occurred with sceneraio I have provided to you and this all rubbish or irrational ? 

No need to pursue to testing or anything ? 

I see no reason for you to lie to me 

Also one more thing which will boost my confidence 

If I don't experience ars symptoms in 10 to 15 days 

Such as extreme fever ,rash and lymnode I can simply move on further ? 

1)how early do ars  occur ? And how late do they occur ? In today's world 

2) what is the percentage people experience atleast one ars symptom if not all

So that I can take some confidence and forget about it 

My apologies for being repetitive but you are professional who is as good as dr hunter if not better and your advice matters 

Thank you and good day 


Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Correct, there is no medical basis for you to be concerned about acquisition of HIV (or hepatitis or other blood borne-STIs) from the situation you describe above.   This your additional questions (which I will answer below) are unnecessary and again demonstrate the influence of the internet on you and your unwarranted fears.

1.  The symptoms of the ARS typically occur between one and two weeks after exposure.  Almost never after 3-4 weeks. 

2.  There are no data on what proportion of persons acquire at least one symptom. Fewer than half of persons who get HIV report ARS-type symptoms.  Most importantly however, over 99% of persons with ARS-type symptoms do not have HIV but have other, non-STI, non-HIV related viral syndromes.

I encourage you to move forward from here.  This thread is now complete and will be closed in a few hours.  EWH

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44 months ago
Thanks doc god bless