[Question #6540] Clarification on conclusive timeline

13 months ago
Good day Doctors.

Follow up on a previous post I had just for clarification purposes of conclusive time frame. 

Brief background from previous question:
Fingered female with small bleed on nail due to biting nails. I got confirmation from Dr Hook being a NO RISK event. 4th Gen Duo, blood work from vein sent to lab (Quest) - Non Reactive ON day 42 post exposure. 

Questions I need clarification on is the time frame. CDC says 45 days. Here reading 6 weeks (42days and beyond). 

1) what is the difference between the two days? (42 or 45)

2) why round it up to 42 days compared to CDC’s 45? 

3) I counted from exposure day Nov 22 and Tested on Jan 3 2020 and it fell ON the 42nd day in the morning and got results that evening.  Does it need to be a full day to be considered 42 days?

4) When blood is collected in the tube, I’m assuming that the blood is still active (alive) by the time it’s tested. 

I appreciate you gentlemen’s time as usual. I believe my results but it’s the tile frame that got me second guessing and seems a lot of others as well. 

Thank you once again and looking forward to your response. All the best. 
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago

Welcome back to the Forum although I must say I'd surprised that you felt the need.  As I told you before, the encounter you described earlier was not low risk, it was NO risk and that there was really no need for testing.  As also explained, the issue so the need for testing beyond 28 days is soft and more based on CDC opinion than any published date.   You are overthinking this.  Please do not go down this "rabbit hole"

Answers to your questions (same answers as before):

1) what is the difference between the two days? (42 or 45)
No meaningful difference

2) why round it up to 42 days compared to CDC’s 45?
I cannot tell you why the CDC has moved from 42 to 45 days.  Once again, there are no published studies to draw upon 

3) I counted from exposure day Nov 22 and Tested on Jan 3 2020 and it fell ON the 42nd day in the morning and got results that evening.  Does it need to be a full day to be considered 42 days?
You can count the interval you used as 42 days.

4) When blood is collected in the tube, I’m assuming that the blood is still active (alive) by the time it’s tested.
The tests are not for living virus but for antibodies and viral antigen (protein).  Standard transport does not effect the accuracy of testing

EWH



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13 months ago
Dr. Hook, pleasure to speak to you again. 

Ha! Rabbit hole indeed sir, more like the ball in a ping pong table. The information throughout websites are so mixed up where I can see this causing people to second guess themselves. Thus the reason I came back here. 

As I said I believe my results but it comes down to time frame that got me confused. 

1) I must ask sir, what do you mean by “no meaningful risk”

2) End of story, my 42 day is Conclusive. 

As I said Dr, I apologize about this and the thoughts got the best of me. Your ADDITIONAL reassurance does make me feel grounded again. 

When I read “45 days”, “anything MORE than 6 weeks”, that I’ve read on here, and so on, it gets me saying to myself “did I wait long enough??” As you said “Rabbit Hole”. 

Appreciate your responses as usual. 

13 months ago
To question 1) I meant to say what do you mean by “no meaningful DIFFERENCE” not risk. My apologies. 
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago
1.   Question 1. Please remember we are talking about an extraordinarily rare occurrence. As I have said to you several times , neither Dr. Handsfield nor I have ever seen or heard of a person who converted their 4th generation HIV test from negative to positive after 28 days. 

2.  Correct, your 42 day test result is absolutely conclusive. (Remember the events you describe have never been associated with acquisition of HIV, not ever.   (It was a no risk encounter.)

EWH
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13 months ago
Dr. Hook, thank you once again for your assurance. 

The reading of other sites and time frames and so on really can mess with the logic of someone’s mind. What I need to do is make your word as final, stop looking up information online and know that even though my situation with the fingering/bleeding may sound relevant, it is not because it’s a No Risk event. 

I will also note that any time in the future, if I MAY really need to be tested, that 42 days is a conclusive result. 

Doctor, I thank you, truly. Cheers. 
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago
Thanks.  Reading between the lines, I think that part of the message I have for you is that the Internet is not your friend.  Much of what is there is taken out of context, out of date, or just plain wrong.  

The bottom line however is that the event you described could not have conceivably led to acquisition of HIV.  Secondly however and for future reference, a negative 4th generation test at 42 days is conclusive and further testing would not be required.  

Take care, please don't worry.  I hope you can move forward without continuing concerns.  This completes this thread.  EWH
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