[Question #985] Pep and testing

51 months ago
Hi dr 

I know I ask a question a few weeks ago about when I got stabbed with a needle and I went on pep and 4 weeks after pep I got tested and came back negative. My question is- I got retested 2 weeks after my 4 week test so 6 weeks after finishing pep and it came back negative! Can you say it's safe to say 6 weeks is conclusive or still wait a few more weeks to get retested again? And is getting pricked/stabbed by a needle a very good chance of getting HIV? As I've read it's hard to as the virus can die quick when in contact with the outside and there needs to be a lot of amount of blood to get injected? It's very confusing as most HIV websites say that sharing needles and equipment can catch HIV that way, and also health care workers are at risk incase they get pricked by s needle? Sorry for the amount I've wrote just really worried by it as this day and age there are a lot of people leaving needles and syringes around and so much info out there I don't know what to believe!
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago

Welcome back to the Forum Chris.  I remember our interchange as well as your earlier interaction with Dr. Handsfield.  The answers to your questions have not changes and I suggest you re-read your earlier posts rather than spending your hard earned money asking repetitive questions.  I say this because the answers will not change.  The official CDC and WHO recommendations remain that PEP follow-up testing should be done out to three months after completion of PEP.  As I explained, our belief is that these recommendations are overly conservative and we have complete faith that you did not get HIV from the event you described involving a needle stick with a needle used by a drug user but for whom you did not know if the person had HIV or not.  In fact, I have copied one of the statements I made to your earlier questions into this response.  It said- "Your chances of having contracted HIV are infinitesimal.  The RECOMMENDATION from the CDC and World Health Organization is that you should have a repeat test at three months.  This recommendation is likely to be overly conservative but that doesn't change the FACT that today that is the recommendation.  If I had a million dollars to bet, I would not hesitate to bet that any further follow-up tests related to the possible exposure you describe will be negative."  that is still my belief and your six week results only reinforce what I (and Dr. Handsfield) have already said.

There have been many studies of the risk of getting HIV following a needle stick from an infected person.  Estimates are, IF THE PERSON IS KNOWN TO BE INFECTED, are between one in 300 and 1 in a thousand (ie. between 0.3% and 0.1%).  As I understand it, you do not know that the person who had used the needle you were stuck with had HIV making the risk much lower, even before you took the PEP and with PEP the risk is lower still.  At this point, you are far more likely to be struck by lightening than to get HIV from the needle stick you have described. 

Reading through both this and your earlier questions however, I worry that about the psychological trauma of this exposure to you and wonder if yu have spoken with anyone about these concerns.  With all due respect, my sense is that you are having a lot of trouble moving forward from this event and could use a little bit of help by talking this through with someone.  I say this out of concern for you, not for any other reason.

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51 months ago
Thanks for the reply back dr this incident has really affected me as I have a new born baby and this has never happened to me before and when I've read up and had people say there's a big chance I can catch it from what happen to me I've got so worried and anxious it's ruined my life! Sorry I've gone on a lot just need a top expert to say yes 6 weeks after testing in conclusive . 
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago
Not a problem Chris.  It is clear to me that this event has affected you profoundly.  My sense is that you are probably going to the internet for information.  This is not a good idea.  Experience shows us that you are far more likely to be misled by what you will find there than to get good information.  I urge you to stay off the internet and, once again, to talk this through with a counselor.  A great starting point would be for you to print out ALL of your interactions with Dr. Handsfield and me, and sharing it with the counselor.  Really.  EWH
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51 months ago
Ok thank you I will, but to put this to bed is being negative at 6 weeks should be conclusive?
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago

Chris.  Your questions are repetitive and you do not appear to be hearing anything that I have said in this or prior threads.  Please read my reply above, as well as my earlier reply.  Your question was answered.

This is my third reply to your questions.  As a result this thread will be closed shortly.  EWH

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