Anonymous
My questions are the following:

1- If a person simultaneouly exposed to HIV and other viruses such as HCV, HCB, EBV or CMV, will the window period exceeds 90 days.
I am more curious about simultanous infection from HCV and HIV.

I read some papers on this topic but still there is confusion. In most cases primary HIV symptoms appeared first and there was no delay in the seroconversion. However, one paper descirbes a case of health care worker where she was exposed to HIV and HCV simultaneously and she seroconverted for HCV after 8.5 months and for HIV after 10.5 months. Disease progression was very fast in she died after several months.

2- So, in such cases  (i.e HIV and HCV coninfection and HCV  seroconversion earlier than HIV seroconversion) can 4th generation combo test will be able to dectect HIV after 3-4 months?
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helpline-volunteer

Hello,


Thank you for your inquiry. From what we gather from the question, you were asking about how the window period for HIV detection changes if there is a potential co-infection. As per Canadian AIDS Treatment Information Exchange, "Fourth-generation HIV tests can detect HIV infection in 50% of people by 18 days after infection; 95% of people by 34 days after infection; and 99% of people by one and a half months after infection". The longer one waits, the conclusiveness of the test increases. The test detects the virus itself (P24 protein) and antibodies to the virus. 

From examining this information further, I am assuming you are referring to the three cases that were documented to have occurred in health care workers and they seroconverted (tested positive) greater than 6 months later post exposure to the virus. I was able to identify the article you were referring to: https://www.nejm.org/doi/full/10.1056/NEJM199703273361304, "Simultaneous Transmission of Human Immunodeficiency Virus and Hepatitis C Virus from a Needle-Stick Injury" (Published in March 1997). Take into consideration, that antiretroviral therapy can delay the accuracy of the window period and it is standard for hospital protocol that if a health care worker is potentially infected by HIV through a workplace accident they would be placed on antiretroviral therapy immediately. Additionally, due to lack of information available it is unclear if a co-infection with Hepatitis C has an influence on HIV testing accuracy.

Therefore in conclusion, there are rare cases documented in literature that have delayed seroconversion and it is unlikely that a co-infection will affect these results. Furthermore, there is significant literature information available that shows 4th generation combo test will have an accuracy rate of 99.9% three months after an exposure.  

Take care,
AIDS Vancouver Online/Helpline,  Kane 

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