[Question #4449] Following up. HIV RNA/testing

28 months ago

Hello Doctors,

Although my previous ‘thread’ has not closed, I did want to respect the three reply rule.  To recap my situation, because I am not sure who will respond…While at work exactly 9 days ago, I placed a pulse oximeter on a patient’s finger who has HIV/AIDS. After taking it off of the patient’s finger, the pulse oximeter snapped and the spring that is threaded from the inside came undone and poke into my palm.  It tore through my glove and took a very small piece of skin.  The cut was seemingly superficial. It did not seem to bleed and I did not have to apply a band-aid afterward.  The part of the pulse oximeter that poked me did not have contact with the patient’s finger.  No blood was visible on the patient’s hand, the pulse oximeter probe, or my gloves. Some skin flakes from the patient were left behind on pulse oximeter probe, but again, the part that poked me unraveled from inside so did not touch the patient’s finger directly. Doctor Hook and I agreed, this should be no risk.  However, the “what if” part of my mind is causing me severe worry.  I am considering getting an HIV RNA mainly for peace of mind.  I do expect the results to be negative and am just hoping the negative result will give me peace of mind to move on. My question is regarding the HIV RNA through STDcheck.  They say 9-11 days.  Dr. Hook mentioned the test should be conclusive at around 14 days. If I get the blood drawn this coming Saturday that will be exactly 13 days plus 8 hours (Give or take). Should that provide a conclusive result or should I wait until 14 days has passed? Also, is it necessary to follow this up with a 4 week 4th gen? Sorry for the repetition. Thank you.


28 months ago
Just wanted to add that although no fresh blood was visible on patients hand/fingers, the patient did have some scabs or dried blood. Hard to tell. However, this should be irrelevant as the part that poked did not have direct contact with patient. Question is more related to testing but wanted to provide exact details. Thanks!
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
Welcome back to the Forum.  Thanks for respecting our three reply guideline- I'll close our earlier exchange after I reply.   I am also sorry you continue to worry about the event you have described so thoroughly (thanks- the information does help).  Re-reading the description does not change my assessment, I am confident that the event you describe does not represent a risk for acquisition of HIV.  that said, as I also acknowledged, I also understand your lingering, "what if" concerns.  It is a natural response and I likewise understand why you would like to have my assessment verified with a laboratory test.

I recommended 14 days as a conservative recommendation.   There are less data on precisely by when all HIV RNA PCR tests would be conclusive- some experts say 10-11 days, others say 14.  I am in the latter group.  Please remember that when HIV RNA PCR tests are used to diagnose recently acquired HIV, far more than 99.9% of these tests are negative because most people who test have not acquired HIV.  Of the remaining 0.1%, when they are tested varied.  In your case, I am confident that a test taken at 13 days will be accurate and will be negative.

I hope that this information is helpful.  If there are further questions, please use your follow-ups to ask for clarification- I don't want you to worry. EWH
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27 months ago
Hello again Dr. Hook.  My hiv rna test through stdcheck  was negative for hiv as we projected. Any need for any further testing? Or considering the “no risk” exposure should I deem the results conclusive? Thank you!
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
Thanks for the follow-up and for sharing your test results.  with a negative RNA PCR at 13+ days you can be entirely confident that you did not get HIV from the very low risk event that you have described.  I see no need for further testing.  It is now certainly time to put your concerns aside and move forward without continuing concern.  I hope you will. EWH---
27 months ago
Dr. Hook,
Thank you for your response. I actually got the test done at 15 days. Hopefully, that is even more conclusive! I will now try to put this behind me. Thank you so much for your kind words and help. 
27 months ago
Dr. Hook. One more question. I noticed you refer to the HIV test I had done as PCR but it is not called that through stdcheck/quest lab.  They call it HIV 1 RNA, QL TMA.  Is this the same thing as PCR? Are my results still conclusive at 15 days? Thank you !
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
PCR is a generic term for nucleic acid amplification tests which include polymerase chain reaction (PCR), and transcription mediated amplification (TMA) as well as other typies of assay.  They perform in equivalent fashion. .  The TMA (Transcription medicated amplification) test used the same principles and concepts to measure the presence of virus and is equally reliable.  As I said earlier, you results are reliable and should be believed.

This is my 3rd response to your questions and therefore, as per forum guidelines, this thread will be closed in a few hours.  I urge you to understand and believe that you did not get HIV from the no risk event that you described in your original post.  It is time for you to move on without concern.   There is NO need for more testing.  EWH
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