[Question #939] Coinfection and risk

50 months ago
Hello, I had one question left in my thread (question 873) but it has been closed.

I ended up having a rapid 4th generation test at 90 days which at the time was purely for psychological reassurance and closure, as I had accepted my test results. 90 day test was nonreactive. I moved on and didnt think about it, but the past days I've had a dull sort of pain in what I believe to be my liver area. I plan on setting an appointment to test for hepc and a general check up. 

1. My original exposure was snorting cocaine immediately (seconds, less than a minute) after someone who later claimed to have full blown AIDS. Dr. Hook said it carried a small risk, and from what I have seen it also carries a risk for hepc transmission. I have read that getting infected with hiv and hepc in the SAME exposure would delay the time it takes for a positive test. Is this possible? Do i need to go back at 6 or even 12 months? 

2. Along those lines, what does small risk mean? Have there been actual, confirmed cases of people acquiring  HIV (or hepC) from this? Dr. Hook was very vague about it, emphasizing the may in his statement that " a very small number of case in which people MAY have acquired HIV this way" Is this an actual risk?   

3. Finally, I tend to have sweaty palms, but my hand was sweating more profusely than usual the day of the 90 day test. I dont think this affected it since the control line indicated it was a good test, per the tester, but just to be sure could my very sweaty finger have made the test unreliable?

My fears that I acquired and could have infected or could infect my partner have returned. Thanks. 

Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago
Welcome back to our Forum.  I'm sorry that you continue to worry about this exposure.  Here on the forum we do our best to provide precise answers when there are date available but some events that we are asked about are so rare that they are not readily studied.  There are a very few (I would guess less than 10) instances in which persons have been shown to get HIV from sharing devices used to snort cocaine, despite the fact that such devices have been shared between infected and uninflected persons thousands and probably millions of times.  Thus it is simply not possible to provide you with the numerical estimate that you seek.  Further, whatever you have read, on the Internet I presume about dully acquired HIV and hepatitis C acquisition delaying test possibility is unproven, unstudied conjecture and the sort of things found all too often on the Internet that unnecessarily worry our clients.  You should believe you 90 day test results.

As for question. Number three, no, sweaty fingers would not effect your test results.

I hope these replies will help you move forward from your continuing concerns.  EWH
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50 months ago
Thank you Dr. Hook,

Believe me I want to and I'm trying very hard to put this behind me.

1) Since clearly there is an HIV risk involved with sharing snorting equipment, if I should ever engage in cocaine use again, should I never share equipment?

2. ) Was I at real risk for hepc? I plan on testing, so how long after exposure would I obtain conclusive results? 

3.) So, simultaneous coinfeciton between hov and hep does not delay test results, therefore is my negative 90 day rapid test for HIV conclusive, meaning I dont need to go back at 6 and 12 months, and I defintively havent and cannot infect anyone? 

Thank you again. 

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

1.  "Clearly" is too strong a word- while there is a risk you are more likely to be struck by lightening.  As for continuing to snort cocaine, this is a personal choice with many possible medical complications including heart attacks (which occur as a result of cocaine snorting far more often than HIV).   Clearly sharing the "equipment is not a good idea either.

2.  Is it theoretically possible- sure.  Is it likely, no.  Please let us know your test results.  I am confident that your did not get hepatitis C from snorting cocaine but if your test should be positive, I would learn something.

3.  correct, no good biological reason to think that results would be meaningfully delayed if you happened to get both infections at once.  No, you do not need to go back 6 or 12 months. 

EWH

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50 months ago
Thank you Dr. Hook. 

 Would the hepc test be conclusive now? Or what is the time after exposure that it would take to be conclusive? 

Can you please leave this open so that I can post results? I had a leftover question i didnt use from my previous thread so it would even out. It seems I have to go to my GP to get the test, and it takes a few weeks to get an appointment.  

In the meantime, I will try to accept that i do not have hiv and cannot infect anyone.  

Thank you. 

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

Yes, a hepatitis C result would certainly be conclusive at this time, more than 90 days after the event you described. 

I'll be happy to leave this post open so you can post your result.  I am confident it will be negative but as I said, I'm always prepared to learn if I'm wrong.

Take care and stay safe.  EWH

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49 months ago
Hello,

I went with my pcp, they did a hepatitis panel 116 days after exposure and everything came back negative. They didnt tell me what type of test, but at this point they all seem to be conclusive according to you and the doctor. I started seeing a psychiatrist to deal with this but it didnt fully work as he insisted an hiv test is only conclusive at 6 months. I will continue to try and move on. Thanks for your support. 
Edward W. Hook M.D.
Edward W. Hook M.D.
49 months ago

Thanks for your follow-up, I appreciate it and congratulate you on seeking help in dealing with this.  It does sadden my that your psychiatrist mistakenly insisted that you needed further testing.  As an infectious diseases specialist, I can completely assure you that your test results PROVE that you did not acquire hepatitis through the cocaine snorting event you described above. 

As per Forum policy, this thread will now be closed- I wish you the best.  EWH

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