HIV - Prevention Expert Forum
budesonide effect on HIV antibody test for my 3 year old.
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budesonide effect on HIV antibody test for my 3 year old.

Dr,
   My 3 year old had a blood contamination incident which visiting a doctor in genetics and that is the reason i am very much worried is that she is falling sick all the time.

Before the incident i rarely remember taking her to the doctor once every 6 month.



After that incident she is continously falling sick once or twice very month with runny nose, cold, cough and sometimes fever. It has been close to one year now and we are dealing with the same situation day in and day out.

It is very rare that is she is not having runny nose or cold,cough. May be i can think of one week in a month she is good, and three weeks she is having this problems.  

After three days after the blood was drown, she had high running nose, cough, and after seven days after the blood was drawn, she has high fever from the past four days including the running nose and cough, and is taking ibuprofen to control the temperature, and an antibiotic as well.


She uses Albuterol, budesonide(oral inhalers) in her nebulizer and some antiboitics(if she has fever), she takes Nasonex shots, and she uses Waldryl allergy and Zyrtec.


I discussed the situation with my pediatrician and because of the blood contamination incident, we got her tested for Hep A, Hep B, Hep C and HIV after 5 months 20 days after the incident.


Now she is 4 years old.


My question to you doctor is do you think using these medications either budesonide or those antibiotics or those Nasonex shots or Waldryl,Zyrtec.


Do these medications or treatments cause a wrong HIV antibody test result or a delay. Would that in any way affect my test results/ antibody production?


They did a western blot for HIV without doing an elisa, it was negative.
239123_tn?1267651214
Welcome to the HIV forum.  Thanks for your question; I'm pleased to help.

Sometimes the title of a question contains enough information for an accurate reply.  Butesonide is an immune-suppressing steroid used by inhalation, so I assume your child has asthma.  Used as intended, the drug exerts effect entirely in the respiratory tissues; although absorbed from there into the bloodstream, it is very rapidly excreted in the urine, and levels in the blood are trivial.  They are nowhere near enough to have any effect on any blood tests of any kind.  For HIV testing, the only immune suppression treatment that might have any effect on reliable results would require very high doses of very potent drugs, of the sort used in cancer chemotherapy and for other life-threatening conditions.  And even this is theoretical only, with no reported cases (to my knowledge) that it actually happened.

So all that is in response to the title of your question.  Now that I have read the res, I think you'll agree I already nailed it.  There is no chance that the butesonide, or any of her other medications, gave her a false negative HIV test.  For sure she doesn't have HIV.

To my knowledge, there have been no documented HIV transmissions due to contamination in medical officices in the past 20 years.  However, since your pediatrician obviously considered her at risk for HIV and several other blood borne infections, I assume the exposure indeed was risky.  However, the test results for all those viruses, in addition to HIV, also are very reliable and prove she wasn't infected.  And her symptoms don't suggest HIV or those other viruses, which do not cause runny nose, cough, etc.  (As you likely know, these are typical allergy symptoms, which are extremely common in kids with asthma.)  But regardless of the exposure, and even if your daughter had typical symptoms of HIV, hepatitis, etc, her test results prove she doesn't have them.  You needn't be worried at all.

I hope this helps calm your fears.  Continue to work with your child's prediatrician about her symptoms, but don't worry about HIV or other blood borne infections.

Best wishes to you and your daughter--  HHH, MD
5 Comments
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Avatar_m_tn
Dr. HHH,

Thanks for your reply.

It was a very unfortunate Dr. HHH, and it was a risky blood contamination incident in the genetic clinic.  

I should have asked you these two questions while i was asking you earlier.

1) The HIV antibody test(Western Blot) was done 5 months 20 days after the exposure. Is that enough window period considering she is a 3 and half year old. or do kids have longer window periods. I see everywhere for adults the window period is 3 months, and am not sure about the 3 year kid.
2) Does any antibiotics(i don't remember which antibiotics she used) have any effect on her HIV antibody test result by delaying or hiding the antibodies.
3) Does any of her immunizations have any effect on the HIV antibody test result?. She got her 3 year immunizations five months before the HIV antibody test.  
4) Does her Nasonex(steroid) or waldryl alergy (allergy) or zyrtec/singular have any effect on her HIV antibody test result?

Our pediatrician has told us that she has allergies, but not asthma. So i am not sure about asthma.

I am sure you were referring to budesonide in your reply and not butesonide.
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239123_tn?1267651214
1) I took the timing into account in my reply above.  The Western blot is always positive within 2-3 months of a new HIV infection.  The window period is no different at different ages.  The test result proves your daughter was not infected.

2-4) There are no antibiotics other medicines, or immunizations that have any effect on HIV test timing or reliability, and I already said that none of your daughter's medications have any effect.  I haven't changed my mind in the past hour!

Sorry if I jumped to conclusions about your daughter having asthma.  It's the most common use for budenosonide (sorry for the misspelling), but it's also used for respiratory tract allergies.

I'm sure your daughter's pediatrician has reassured you about HIV and other blood borne infections.  Now you have heard it from me.  It is time to put that unfortunate incident behind you.  However upsetting and stressful it has been, it should now be a closed chapter in your life.  All is well.
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Avatar_m_tn
Thanks for your expertise and your precious time. It means a lot to me. Our pediatrician has told that he will test her after one year one more time. I did not ask him about the budasonide effect or having allergies effect on the HIV antibody test as i did not think anything about it at that point of time. I was looking online and found this site, read something about steroids all that so i asked. After reading your comments i think i can be assured and forget about it.

Thank you.
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239123_tn?1267651214
Thanks for the thanks.  You might be further reassured by the discussion in the thread whose link is below, which discusses the reliability of HIV testing:

http://www.medhelp.org/posts/show/1704700
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