Are HIV and hepatitis B test results conclusive at ten weeks of post exposure?

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

The laboratory tests you took are negative for viral illnesses possibly transmitted by needle stick injury, primarily HIV (human immunodeficiency virus). However, it is a good idea to keep getting tested yearly.

Other STDs (sexually transmitted diseases), for example, bacterial infections such as treponema pallidum and syphilis, are transmitted via a sexual mode of transmission. You have undertaken this test as well.

Did you also have unprotected sexual exposure? If not, you need not have undertaken this particular test.

HbsAg antigen testing could also have been done to know a possible hepatitis B transmission. Kindly do it before you go for a booster dose.

Kindly share the hepatitis B antibody test report, which you have undertaken since you have mentioned it but not shared the report.

Are you a healthcare professional considering you have a needlestick injury?

The risk of HIV transmission with needlestick injury is very low and has less scientific evidence. Please keep this in mind the next time you have similar exposure, such as needlestick injury or unprotected sexual exposure. In such exposure situations, as per HIV guidelines, post-exposure HIV prophylaxis with three-drug therapy started within 72 hours of needle stick injury should have been undertaken by a qualified physician, infectious diseases, or public health physician.

Are you likely to have a possible risk of further exposure? If so, kindly visit your local HIV, infectious disease, internal medicine, or public health physician for being under pre-exposure prophylaxis with two drugs (example: TAF- Emtricitabine or TDF- Emtricitabine) therapy. Also, please keep getting the HIV tests done yearly since the virus may be dormant for many years in rare cases.

Yes, HIV and HbsAg antigen and anti-hepatitis B antibodies are non-reactive and do not suggest detecting either virus. It would have been ideal to have Hep A (hepatitis A) antibody and HCV (hepatitis C virus) antibody titers for hepatitis A and hepatitis C, respectively.

The rate of occupational transmission from the blood of an HIV-positive source is believed to be 0.3 % for exposure via skin and 0.09 % for a mucous membrane (nose, eye, mouth).

Exposure to intact skin is at no risk of transmission if removed in a timely fashion via washing.

The transmission rate from a hepatitis B positive source to a non-immunized host is 6 % to 24 %, and 1 % to 8 % for exposure to hepatitis C. Hepatitis B infectivity depends on the hepatitis B e antigen (HBeAg) status of the source. If HBeAg is positive, the transmission rate can be up to 30 %, but when negative, it is 1 % to 6 %.

As per updated guidelines for the management of needlestick injury, the following needs to be done:

1. HIV testing.
2. Hepatitis B antigen.
3. Hepatitis C antibody.
4. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels.
5. Alkaline phosphatase levels.

The variety and frequency of tests are as follows in case of continuous exposure:

1. HIV testing at the time of the incident and again at six weeks, three months, six months, and once every year.
2. Hepatitis C antibody at the time of the incident and again at two weeks, four weeks, and eight weeks.
3. Hepatitis B surface antibody (once before starting any prophylaxis).
4. Hepatitis B surface antigen - Immediate and once every year.
5. Hematology- Before starting any prophylaxis, complete blood count with differential counts and platelets and ESR (erythrocyte sedimentation rate) every year.
6. Blood biochemistry- Once every year, serum creatinine or BUN (blood urea nitrogen) levels, urinalysis with microscopic analysis of AST and ALT levels, alkaline phosphatase level, and total bilirubin level.

Thank you and take care.

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern.

The tests I mentioned will ensure you are constantly monitoring your health and the possibility of at-risk diseases.

We can discuss this further in case you need it.

Thank you and take care.

Hi,

Welcome back to icliniq.com.

I could not find anti-HCV antibody values in the attachments (attachments removed to protect the patient's identity). Kindly paste the detected and laboratory average values of the laboratory report of the anti-HCV antibody.

Please let me know if you have any symptoms since your liver function test values and renal function parameters are within normal limits.

The only deviation which could be found in elevated lymphocyte count suggests infection. The lipid function tests are also deranged, probably related to a lack of control of these parameters or a lack of lipid-lowering medical treatment.

Thank you and take care.

Hi,

Welcome back to icliniq.com.

Thank you for uploading the report (attachments removed to protect the patient's identity). The uploaded report shows no detected HCV (hepatitis C virus). I do not understand why you mentioned earlier that the test was positive. Please clarify.

For your lipid function abnormality, I suggest you take the tablet Atorvastatin 20 mg HS for three months and retest. However, please consult with your physician and then take the medications under their consent.

I would also suggest you undertake tests for blood sugar detection, especially HbA1C (glycated hemoglobin), fasting, and postprandial blood sugar, and share the results.

And please do not forget to consult a local doctor regarding pre-exposure prophylaxis (PREP) for HIV if you have an occupational exposure hazard of sustaining needlestick injuries or have unprotected sexual exposure.

Thank you and take care.