On the job exposure

Hello Doctor,

Thanks for your time. I am in a weird situation and the last 43 days have been a huge living nightmare. I work in a healthcare setting in India and had a high risk exposure (1 in 300 chance of infection). At that time, I did not realize it was a high risk exposure and hence did not consider taking PEP. By the time I realized, it was too late. I have not had any ARS "symptoms" yet.

Anyway, so I got tested today (6 weeks and 1 day later):

HIV 1 & 2 MEIA
HIV 1 & 2 antibody + HIV 1 P24 Antigen (DUO)

The questions I have are

1) Are these fully conclusive to prove that I do not have HIV 1 and 2?

2) I am specifically concerned about HIV 2 since what if 6 weeks 1 day was not sufficient to develop antibodies?

3) Any further tests required?

Thanks again.

[Edward W Hook, MD]

Welcome to our Forum.  Your question can be essentially summarized as "how reliable are the tests for HIV at 6 weeks”.  The first test you refer to (HIV 1 & 2 MEIA) is most probably a traditional antibody test.  Test tests would be expected to detect about 95% of infections acquired 6 weeks earlier.  The other test (HIV 1 & 2 antibody + HIV 1 P24 Antigen (DUO)), because it includes not only the antibody test but the p24 antigen test as well, is more sensitive and would be expected to have detected virtually ill infections acquired any time more than 4 weeks ago. thus your 6 week test results are highly reliable and indicate that you did not get HIV from your exposure 43 days ago.  EWH

[crazyfoolish]

Thanks Doctor for your response.

I understand that HIV 1 is not a concern now (inferred from your reply).

I am concerned about HIV 2. Are my tests sufficient to rule out that 100% or do I need to repeat the tests after 8 weeks or 12 weeks?

[crazyfoolish]

Hello Doctor,

Can I rest assured 100% for HIV 2 as well or do I need to take more tests?

Thanks.

[Edward W Hook, MD]

Most tests test for both HIV 1 and HIV 2.  I woul not worry further. EWH

[crazyfoolish]

Thanks. So at 6 weeks, the tests for HIV 2 are conclusive.

Last question. I promise.

[Edward W Hook, MD]

The performance characteristics are similar for each virus.  At 6 weeks standard antibody tests detect over 95% of infections. With the DUO tests the proportion goes up.  There is nothing more to say.  EWH