Former IDU testing for HIV/Hepatitis, believe results?

[notelobby]

Hello Doctors,
For a brief time I used injectable performance enhancing drugs, several years ago.  I never shared needles of course, but I did receive them from a friend.  We used insulin syringes, and although I think they were sealed, I have doubts about my memory.  I have already had a negative oraquick HIV test.  I think I should also test for hepatitis and do an HIV blood test.
1.  How would you suggest I move forward with testing?  Specific tests I should request?  Any other tests I should look for?  HTLV perhaps?

2.  I don't know what risk category I fall into.  I imagine I could qualify for high risk even though my drug use was brief, or is that category resolved for street drug users who regularly share needles?

3.  I have read that false negative are very rare and predictive values in the general population for both hepatitis and HIV are very good.  Something like only a few in thousand would get a false negative.  Since I have used injectable drugs, I imagine I would not qualify for general population... what are my chances of a negative result being a false negative?

I am a white male, if that matters.

[H. Hunter Handsfield, M.D.]

I'm confident the 99% accurate figure is correct.  Sorry for the type.

[notelobby]

Sorry Dr. Handsfield, I assume you meant that you have no reason to believe that the greater than 99% accuracy ISN'T correct, right?  As in, 99% or above is typical accuracy for HIV blood tests?    I don't mean to be nitpicking, just unclear on that statement.

[H. Hunter Handsfield, M.D.]

Most likely the syringes were unused.  I'm definitely not a substance abuse expert (and this whole topic is a bit off for this forum) -- but I would guess that even recycled, repackaged needles and syringes would have been sterilized.  The main risk from shared injection equipment comes when people pass the works directly from on to the other, each injecting in turn.

I have no reason to believe the >99% accuracy is correct.  Based on all you say, you can expect negative test results.

That should wind up this thread.  Best of luck and best wishes for success in staying clean.

[notelobby]

Thank you Dr. HHH!  The only test I have had so far is the oral HIV test... I haven't made my doctor's appt for any other tests yet, actually... but your comments are reassuring that I can trust my results when I get them, all the same.  

Also I should add I never 'knowingly' shared injection equipment, but the syringes were not commercially acquired.  Since the syringes were not store bought, but were given to me by my friend, I can only assume they were never used.  I remember unpackaging some sealed syringes, but I do not remember if they were ALL sealed.  I find it unlikely they were used, but I want to test all the same.

Would it be reasonable to say the accuracy of my upcoming tests will be >99% accurate as I read online?

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

It sounds like you went about your injection drug use in a maximally safe fashion. Good show.  Your negative blood test results are completely reliable.

1) I'm now aware of data on HTLV and association with injection drug use.  But if there's a risk, never sharing injection equipment is effective prevention, just as for the other blood-borne viruses you didn't catch.  I don't recommend testing for it.

2) I would classify you as very low risk for blood borne infections.  But what does it matter now?  However high or low the risk was at the time, you weren't infected.

3) I see no reason to be concerned about the rare possibility of false negative resuts.

Best wishes--  HHH, MD