I have seen that happen recently: HCV PCR Negative at 6 weeks and then positive at 3 months. This particular institution was still following the 6 week, 3 m and 6 m post-exposure labs. The 3 month lab could have
been HCV antibody only but they did HCV antibody and by PCR “secondary to high risk positive source”. At 3 months, PCR was positive and antibody to HCV negative.
Saj
Sajjad A. Savul, MD, MS, FACOEM
Associate Program Director, Occupational and Environmental Medicine Residency
Assistant Professor, Department of Emergency Medicine, University of Pennsylvania
Medical Director, Occupational Medicine, Penn Presbyterian Hospital
3400 Spruce Street
Ground Floor Ravdin
Philadelphia, PA 19104
Phone: 215-662-4220
Fax: 215-662-7133
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of Leslie Thompson via MCOH-EH
Sent: Monday, March 19, 2018 2:30 PM
To: MCOH/EH <mcoh-eh@mylist.net>
Cc: Leslie Thompson <Leslie.Thompson@sharp.com>
Subject: Re: [MCOH-EH] BBP exposure serial testing
We did the same but decided based on the most recent update to UCSF Clinical Consultation center to test Hep C Ab at 6 months as there is a possibility of false negative with the early PCR.
http://nccc.ucsf.edu/clinical-resources/pep-resources/pep-quick-guide/ (Exposures to HCV)
Leslie
Leslie Thompson, RN, MSN, COHN-S
Manager, Employee Occupational Health Department
Sharp HealthCare
8695 Spectrum Center Blvd
San Diego, CA 92123
P: 858-499-5264 F:858-499-5317
From: MCOH-EH [mailto:mcoh-eh-bounces+leslie.thompson=sharp.com@mylist.net]
On Behalf Of Rolando, Lori
Sent: Monday, March 19, 2018 09:32 AM
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] BBP exposure serial testing
[EXTERNAL SENDER]
We use the 4th generation combination HIV Ag/Ab test for employees post-exposure, so we do testing for HIV at 6 weeks and 4 months based on the current recommendations (see first linked document under
“Protecting Healthcare Personnel from HIV” at
https://www.cdc.gov/hai/organisms/hiv/hiv.html Summary on page 3 and page 27 for detailed info )
As far as Hepatitis C testing , we do Hep C PCR at 6 weeks (can be any time after 3 weeks, so since the person is coming back for 6 week HIV, we do both at the same time) and if that is negative, we do not do
any further testing. Based on new algorithm from CDC. https://www.cdc.gov/hepatitis/pdfs/testing-followup-exposed-hc-personnel.pdf
Lori A Rolando, MD MPH FACOEM
Director, Vanderbilt Occupational Health Clinic
615-936-0955 (p)
615-936-0966 (f)
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of Morelli, Karen J
Sent: Monday, March 19, 2018 11:11 AM
To: 'mcoh-eh@mylist.net'
Subject: [MCOH-EH] BBP exposure serial testing
Good Afternoon,
I would like to hear what others are doing for blood borne pathogen serial test timing. We had been doing testing at 6 weeks, 3 and 6 months for HIV, Hep C and Hep B. However, looking at the CDC guidelines, depending on the pathogen,
baseline and at 6 months may be all that is recommended. I am in the midst of updating our policy to reflect what the CDC recommends but wanted to get your input as well.
Thank you!
Karen
Karen Morelli RN, BSN, Clinical Manager
WorkHealth LLC
973-7382
BANGOR | PITTSFIELD | PORTLAND | PRESQUE ISLE