I am a doctor. 14 days ago I had a very minor needle stick injury (25g needle, infiltrating subcutaneous local anaesthetic, superficial injury (finger only bled with squeezing), no visible blood on needle). I am unsure of patient's HIV status but from low risk group. I bled and washed the finger. (Foolishly) I did not report the injury as I deemed risk was negligible. 2 days ago (12 days post injury) I developed flu like symptoms (low grade fever, sore throat). I realise that this is almost certainly an incidental viral URTI but nonetheless I am now very anxious. I have now reported the incident to occupational health but they have told me I have to wait until 6 weeks to be tested. I have read on line that HIV duo is quite sensitive from as early as two weeks. How accurate is the test in the context of symptoms? Should I get the PCR instead? Many thanks for any advice.
Hello and thank you for contacting the AIDS Vancouver Helpline. We are happy to answer your questions.

It sounds like you are worried about acquiring HIV from the needle-stick injury that you have described here. We want to let you know that superficial cuts/broken skin do not usually provide direct access to the bloodstream, and it sounds like the injury you sustained from the needle was pretty minor (since it can heal on its own). To answer your question, the duo HIV test (a.k.a. 4th Generation EIA) can give you a good indication of your HIV status earlier than other HIV tests, but the safest measure would be to be tested for HIV again when the results of the test can be considered conclusive. We are glad to hear that you decided to report the incident to your workplace since it is a great way to assure you receive any support you may need.

Symptoms cannot tell us if an individual is living with HIV or not; only an HIV test can. We always suggest being tested at the time when the results of your HIV test can be considered reliable and conclusive, but you do have options for earlier testing:

The 4th Generation EIA test:

Many HIV specialists consider the results of the 4th Generation EIA test conclusive at 6 weeks post-exposure (accuracy higher than 99%), and we always encourage individuals to follow guidelines from their local healthcare professional(s) when carrying out HIV testing. Here at AIDS Vancouver, we use guidelines from the BC CDC that suggest the results of all HIV tests can be considered conclusive at 12 weeks (84 days) post-exposure.
So, the 4th Generation test is NOT highly conclusive as early as two weeks (it is at 6 weeks though). Given that the 4th Generation Test is very accurate and is relied upon by many HIV specialist, we suggest you rely on it for your results.

Hoping that this addresses all your questions and concerns.

In health,

Marta & Moe- AIDS Vancouver Helpline Volunteers
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