Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.Hello, I'd like you to know that I appreciate your website; it has been of great help to me.
My question:
On Friday 12th May I had the unfortunate accident of being exposed to an HIV infected patient's blood through a needle stick. The Hospital initiated their protocol; they put me on PEP and gave me a PCR test which came back negative. I have been taking the 3 drug PEP since.
I'd like to know how reliable you think a PCR test's results are if given within 2 hrs post exposure. Since the test is a direct measurement of viral load, it seems to me that testing so close to the time of the exposure is not a reliable way of assessing infection. I know I have to take an Elisa antibody in the near future, however the anxiety is overwhelming and I would like to take another PCR, and I'd like to know when the best time is to do the PCR. I thank you for your time.
Marty Markowitz, M. D.
Clinical Director
Staff Investigator, Aaron Diamond AIDS Research Center
Associate Professor, Rockefeller University
The PCR test is done at baseline NOT to diagnose infection from the stick but to insure that infection did not antedate PEP.
PEP should be taken for 4 weeks. The drug regimen should reflect whether the HIV infected patient harbored drug resistant HIV...this information is not included.
After completing PEP, a PCR done 14 to 21 days later should indicate whether or not it was effective- a viral load greater than 5,000 copies/ml in the presence of a negative antibody test would suggest infection. A positive antibody test at that time or subsequently would also indicate infection. A negative PCR 14 to 21 days post pep would make infeciton highly unlikely.
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