A 29-year-old emergency medicine resident accidentally sticks herself with a blood-contaminated needle while placing a central venous line in a 45-year-old trauma patient. The HIV status of the source patient is unknown, but the source patient gives permission for HIV testing. An HIV-1/2 antigen-antibody immunoassay test is ordered and results will be available in approximately 24 hours.
What would be the best next action step?
![This graph shows detectable plasma HIV RNA precedes detection of HIV antibody in the early days after HIV acquisition.](http://cdn.hiv.uw.edu/doc/149-5/thumb/hiv-rna-precedes-hiv-antibody-persons-recent-hiv-acquisition.jpg)
Figure 1. HIV RNA Precedes HIV Antibody in Persons with Recent HIV Acquisition
This graph shows detectable plasma HIV RNA precedes detection of HIV antibody in the early days after HIV acquisition.
Illustration: David H. Spach, MD
![The HIV seroconversion window period represents the time from HIV acquisition until HIV antibody is detectable with conventional laboratory-based HIV antibody assays. With most point-of-care rapid HIV antibody tests, the seroconversion window is slightly longer than usually observed with laboratory-based HIV antibody tests.](http://cdn.hiv.uw.edu/doc/150-5/thumb/hiv-seroconversion-window-period.jpg)
Figure 2. HIV Seroconversion Window Period
The HIV seroconversion window period represents the time from HIV acquisition until HIV antibody is detectable with conventional laboratory-based HIV antibody assays. With most point-of-care rapid HIV antibody tests, the seroconversion window is slightly longer than usually observed with laboratory-based HIV antibody tests.
Illustration: David H. Spach, MD
![Note the HIV p24 antigen becomes detectable approximately 7 days prior to detectable HIV antibody. Thus, in persons with acute HIV, the HIV antigen-antibody tests detect HIV sooner than with conventional HIV antibody tests.](http://cdn.hiv.uw.edu/doc/627-3/thumb/laboratory-markers-acute-hiv.jpg)
Figure 3. Laboratory Markers with Acute HIV
Note the HIV p24 antigen becomes detectable approximately 7 days prior to detectable HIV antibody. Thus, in persons with acute HIV, the HIV antigen-antibody tests detect HIV sooner than with conventional HIV antibody tests.
Illustration: David H. Spach, MD
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Question Last Updated
February 1st, 2025
February 1st, 2025
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