Dear doctor hunter I am just writing this question by already looking at your past replies so I’m sure the answer cannot change for me as it didn’t for other users 

PLEASE REPLY TO SPECIFIC POINTS . 

I have some general questions 

1)  question: my wife and I took Hiv hepatitis c test (after window period ) for let’s say for  an exposure results came negative. I Just wanted to ask even if I didn’t see my patient ID / barcode on the blood collection tube  when nurse labels the sample with a barcode  sticker results for hiv hepatitis c will still be accurate/conclusive  and not mix with some other patient . ?

Answer : 

2a)  the nurse also didn’t show me my patient ID  and my lab doesnt until you ask  so I’m sure it’s normal?  But most importantly you have said even if you didn’t see patient ID l/label Hiv hepatitis test results will always be accurate/conclusive  as this blood draw method is FOOL proof so no chance wrong labelling of blood sample .

2b)you have said this is  unrealistic concern And there is no need for you to observe the blood draw  procedure so even if I didn’t ask nurse to show me my patient ID/ barocde  label  my negative Hiv hepatitis  b c results are still accurate /conclusive because it’s full proof and no chance fo mixing of blood sample with other patient so nurse will label  my sample correctly 

2c)MY personal doctor told me no need to check blood collection tube for patient ID /label when you have blood draw and if nurse made any  Mistake on labelling your patient name/ID / label they will call you back and take another blood test so I cam believe my personal doctor as well ?

3) question Blood transfusion: you have said no one gets Hiv hepatitis b c unless you have sex or share needles / syringes with other people so I wanted to ask my wife had blood transfusion during pregnancy in pakistan is ZERO RISK 

 for Hiv hepatitis b c the hospital has said that they screen the blood Before blood transfusion. So I’m sure no risk it doesn’t matter if they screen 3 rd generation or 4 th generation testing for blood banks  Because in  urban areas everything is safe .

You have said forget about risk of hiv hepatitis b c from blood transfusion anywhere in the world .and my PERSONAL doctor says the same .

All these points I have read from your past replies surely same answers for me then as well and I can EASE MY MIND . 

1.  Laboratory identification systems are highly reliable and designed to avoid any confusion.  Once labeled, the results should be trusted.  As an unrelated FYI, let me point out that for heterosexual men and women, hepatitis C is virtually NEVER transmitted sexually. The few cases in which hepatitis C has been transmitted have occurred among men with other men as sex partners who receive receptive rectal intercourse.

2a.  Nothing is entirely foolproof however laboratory operating procedures make such confusion virtually foolproof and not worth worrying about.

2b.  Correct.  Believe your test result!!!

3.  If the blood received by your wife was screened for HIV and hepatitis prior to transfusion, it is reliable and safe.  I cannot comment on the blood banking or screening procedures used in Pakistan.  Sorry, I am not familiar with them.  I would presume however that they follow global recommendations.  you doctor's communications appear to verify that.  he is a better source of information on transfusion associated risks in Pakistan than I am.

I hope this information is helpful. EH

1) so I can follow doctors hunters advice that there IS NO NEED FOR ME TO SEE my patient identification sticker / label on blood collection tube for the tests I had or in future  when BLOOD DRAW is done at any point because these labelling systems are designed in such a way that they cannot be wrong so NO NEED TO REQUEST nurse to show me my patient identification on blood collection tube OR anywhere Where nurse labels the blood sample with my patient identification believe my test results are conclusive and they CANNOT GET MIXED with other patient samples  so my results for Hiv hepatitis c or any test are conclusive.

2) sorry you MISSED replying to point 2c . Where my personal doctor said to me he never checks if nurse labelled his patient IDENTIFICATION  labelled correctly during blood draw because he said if nurse would ever make mistake they would call you back and do your blood draw again . So that’s further evidence I don’t need to see my patient IDENTIFICATION label during blood draw  SO I CAN BELIEVE MY PERSONAL doctor as well?

2a) conclusion:so no need to look at patient IDENTIFICATION just give your blood  during blood draw and trust that nurse will label your blood correctly on blood collection tube or anywhere where nurse labels my blood sample . So results are conclusive for Hiv hepatitis c or any other test don’t worry about blood sample being mixed with other patient .

FYI:   Blood collection tube is the the vaccutainer in which blood is sucked and stored and nurse labels it with patient identification 

3) blood transfusion: blood was screened for Hiv hepatitis b c for SURE ! the hospital is one of the best in child delivery everyone goes there so that’s good enough? No risks for Hiv hepatitis   B c  .

4) I believe they do the Elisa test for Hiv  so that’s fine if they didn’t no pcr test for Hiv hepatitis that’s okay ? 

What’s the recommendation? Is PCR NAAT/NRA that same thing for Hiv 

Either way I believe doctor Hunter said no risk for Hiv hepatitis b c just have safe sex and don’t share needle /syringes with other people and don’t worry about blood transfusion in terms of hiv hepatitis b c . So I don’t need to worry for my wife getting Hiv hepatitis from blood transfusion as per doc Hunter 

5) lastly can you tell me what window period for hepatitis c and b is ? . I believe you have written 6 weeks for hepatitis c antibody test only is conclusive.

Thank you 

1.  Correct.  This is a repetitive question. The answer will not change. Have confidence in the labeling system, there is no need for you to be checking on it.

2.  Also correct. Have confidence in your doctors procedures and believe in him. Have confidence that the labeling procedures work. There is no reason to doubt that is the case. The Vacutainer system that you described is typical and commonly used worldwide for drawing blood for laboratory testing.

3.  This is a repetitive question. The answer is unchanged. If the blood was screened before transfusion, you can have complete confidence that your wife was not infected through the transfusion she received.

4.  Testing using ELISA format is the global standard for testing for hepatitis and HIV. There is typically no need for PCR testing.

5.  In recently acquired hepatitis B or C infections, the vast majority of antibody tests will be positive within 30 days of acquiring the infection. Results of tests performed at more than six weeks are certainly conclusive.

I hope this information is helpful to you. It saddens me that you do not have confidence in your doctor or your healthcare system. I hope that my replies will help you help you to feel more confident in the services they provide you. EWH 

Thanks plz clear blood transfusion and testing period .

1) blood transfusion (transplant ): to be clear  screening means the blood bank  is  tested using the 3RD generation antibody test only for hiv and hepatitis b ,c  that is most common and global standard .once negative the blood bank can be used and no risk from blood transfusion to my wife for hiv hepatitis b c  .

2) there is no need for use the 4th generation antigen/ antibody test or pcr / naat etc for hiv hepatitis b c  . But if the hospital wants to perform any of these tests  on blood banks for blood transfusion it is also allowed  if they don’t use 3rd generation antibody test . Right ? 

3) also doctor Hunter says blood transfusion is no risk  for hiv hepatitis b c  and is a thing of the PAST . So once blood bank is screened for 3rd generation antibody  test (hiv and hepatitis b c )   or 4th generation or pcr or any other test doesn’t  matter as long it has been tested /screened   we have no risk for hiv hepatitis b c from blood transfusion. . SO  NO NEED TO TEST MY wife for hiv hepatitis b c she is safe ! 

4) hepatitis c test : could you be please clear this out the test that is conclusive at 6 weeks is the standard Hepatitis C antibody test ? 

  

And what’s the test called for hepatitis b that’s conclusive at 6 weeks  and also for hepatitis c 

Once negative at 6 weeks with antibody test only  NO need to repeat test because Cdc guidelines are different that’s why I’m asking . 

4b) can you tell me is the hepatitis c pcr when is that conclusive?  and what’s  the name of the test 

5) hiv test : hiv  3rd  generation antibody only test  is CONCLUSIVE at 8weeks  as per doc Hunter if one has hiv exposure and no need to test after that . ?

5b) there is NO need to repeat the hiv hepatitis b c test ONCE you have tested after window period as dr Hunter says these tests are sensitive so no fear of false negative and we can believe it to be conclusive . SINGLE TEST IS ENOUGH for these viruses with one blood draw we can test for all these viruses and no need to repeat 

6) final FACT: I have read you have Said hiv hepatitis b , c viruses die immediately  once  exposed to AIR in the blood  therefore  since these viruses are now dead they can no longer infect  me or my family with  hiv hepatitis b c because of air exposure regardless of any risk.

Plz do answer all points 

Regards 

1. Understood.  For blood banking in North America blood is screening using both antibody testing and PCR methods for HIV and hepatitis B and C.  All donations are screened for each donation.  In some other companies tests for antibodies only  are used and may miss a VERY small number of potentially infected donations but this is quite rare.  Screened blood is generally safe for transfusion.  

2. Se above.  There is no reason that 4th generation testing should not be used for testing blood donated for transfusion.

3.  Dr. Handsfield's statement is correct for North America and represents the global standard.  As I said, I do not know what methods are used in Pakistan.  further, I would add that HIV in particular is quite rare in Pakistan.

4.  A. Correct, testing at 6 weeks is conclusive and need not be repeated.  

b.  There are several brands of hepatitis C PCR tests.  In general these tests are conclusive several weeks earlier than antibody only tests.  I cannot comment on how the earliest time that they are conclusive but they are almost certainly conclusive 4 weeks after an exposure.

5.  a.  Correct

b.  Correct

6.  Correct.  These infections are transmitted by DIRECT contact and are not transmitted through casual household contact.

I hope that this information is helpful.  As noted above, this thread will be closed shortly. Take care.  EWH