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post PEP testing.reliability !

Posted: Jun 30, 2007

QUESTION:

Dear Dr., Quick question: A HCW had a needlestick injury involving a pt of known HIV/HepC status in mid April and was then treated with Combivir/Tenofovir for 4 weeks for this exposure. She has had an 8wk ELISA test (neg) on June 11th (4wks after completion of PEP) and a 9wk RNA-PCR test(not-detected) on June 16th (5wks post completion of PEP)for some non-specific symptoms. She is still very anxious about this and having a hard time foucusing on her work. Can you tell me about the reliabilty of these test ? Are they reassuring or not really ? What is the BEST timeline for further testing to definitively rule out the possibility of infection(given that the pt was on PEP for the 1st 4wks)? Thanks in advance for writing back. -RT


  

RESPONSE FROM:   

    She is HIV uninfected. The multiple tests have demonstrated this. She should have a repeat ELISA at 12 weeks post exposure. If negative, the case is closed. I would be very clear here as any uncertainty on your part will only increase her anxiety. If she continues to be anxious to the point of interfering with her life and work, she should absolutely be referred to a psychologist or psychiatrist for care.

    DW




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