Possibly HIV+ But seroconverting before medicals

[Benibenji]

I need help!

Hello forum. I’m new here... got my ITA mid September with a CRS of 473( cut off 471) and was given 90 days till the submission of profile. Currently trying to gather all necessary documents and also scheduled to do medicals mid this month(October). However early (first week) of September, due to the nature of my job I got a needle stick injury from a patient I was managing and after a rapid RVS was done which was non-reactive also history didn’t suggest any risk from the patient, I proceeded not to take PEP. For about 4 weeks now I have been having what seems like an acute HIV syndrome which started with watery diarrhea 2 weeks after exposure and lasted for 2 weeks and then now some form of peripheral neuropathy( started from the legs), dizziness, generalized myalgia, anorexia( lost 2kg in days), headache and drenching night sweats despite the cold weather. Rapid test about a week ago was non reactive. I have tried to rule out other possible causes of my symptoms most especially hypokalemia( result was normal). I am now left to believe that this might actually be a case of acute hiv syndrome. More so in this part of world you hardly see 4th generation Retroviral testing kits which picks up p24antigen and antibodies and can be detected earlier that the 3rd generation test kits. Also if I decide to go for a viral load it would take me about 2-3 months to obtain the result. As regards my application and my high suspicion of seropositivity, should I decline the invitation and wait till to redo the test after 3 months or should I go ahead with the medicals which is scheduled mid this month( of which they might use the 4the generation kit). Also I have a fiancé whom I intend adding post AOR and she is equally exposed from me.

Please forum I need as much advise as I can get... thanks

 

[Lizzybet]

@legalfalcon please can you be of help to this fellow

 

[legalfalcon]

I need help!

Hello forum. I’m new here... got my ITA mid September with a CRS of 473( cut off 471) and was given 90 days till the submission of profile. Currently trying to gather all necessary documents and also scheduled to do medicals mid this month(October). However early (first week) of September, due to the nature of my job I got a needle stick injury from a patient I was managing and after a rapid RVS was done which was non-reactive also history didn’t suggest any risk from the patient, I proceeded not to take PEP. For about 4 weeks now I have been having what seems like an acute HIV syndrome which started with watery diarrhea 2 weeks after exposure and lasted for 2 weeks and then now some form of peripheral neuropathy( started from the legs), dizziness, generalized myalgia, anorexia( lost 2kg in days), headache and drenching night sweats despite the cold weather. Rapid test about a week ago was non reactive. I have tried to rule out other possible causes of my symptoms most especially hypokalemia( result was normal). I am now left to believe that this might actually be a case of acute hiv syndrome. More so in this part of world you hardly see 4th generation Retroviral testing kits which picks up p24antigen and antibodies and can be detected earlier that the 3rd generation test kits. Also if I decide to go for a viral load it would take me about 2-3 months to obtain the result. As regards my application and my high suspicion of seropositivity, should I decline the invitation and wait till to redo the test after 3 months or should I go ahead with the medicals which is scheduled mid this month( of which they might use the 4the generation kit). Also I have a fiancé whom I intend adding post AOR and she is equally exposed from me.

Please forum I need as much advise as I can get... thanks

As per the IRCC guidelines for medicals, the panel physician will only conduct rapid test and if it comes non reactive, the same will be entered in your medical report. So there is no reason for your to wait.

The details of HIV are listed in the IRCC release available at https://www.canada.ca/content/dam/ircc/migration/ircc/english/department/partner/pp/pdf/imei_hiv.pdf

It specifically states:

"A single negative result does not preclude the possibility of HIV infection, but is acceptable as an initial test for IME purposes. Post-test counselling after a negative HIV test result is recommended, but not mandatory for CIC purposes. This would include providing information on the importance of risk reduction. PPs should indicate whether they believe that there may be a high risk of a false-negative result."

For more details, you should consult the panel physician who will be doing your medicals for the purpose of immigration.

Hope this helps!

 

[shomaro]

I need help!

Hello forum. I’m new here... got my ITA mid September with a CRS of 473( cut off 471) and was given 90 days till the submission of profile. Currently trying to gather all necessary documents and also scheduled to do medicals mid this month(October). However early (first week) of September, due to the nature of my job I got a needle stick injury from a patient I was managing and after a rapid RVS was done which was non-reactive also history didn’t suggest any risk from the patient, I proceeded not to take PEP. For about 4 weeks now I have been having what seems like an acute HIV syndrome which started with watery diarrhea 2 weeks after exposure and lasted for 2 weeks and then now some form of peripheral neuropathy( started from the legs), dizziness, generalized myalgia, anorexia( lost 2kg in days), headache and drenching night sweats despite the cold weather. Rapid test about a week ago was non reactive. I have tried to rule out other possible causes of my symptoms most especially hypokalemia( result was normal). I am now left to believe that this might actually be a case of acute hiv syndrome. More so in this part of world you hardly see 4th generation Retroviral testing kits which picks up p24antigen and antibodies and can be detected earlier that the 3rd generation test kits. Also if I decide to go for a viral load it would take me about 2-3 months to obtain the result. As regards my application and my high suspicion of seropositivity, should I decline the invitation and wait till to redo the test after 3 months or should I go ahead with the medicals which is scheduled mid this month( of which they might use the 4the generation kit). Also I have a fiancé whom I intend adding post AOR and she is equally exposed from me.

Please forum I need as much advise as I can get... thanks

The panel physician is just testing the antibody of HIV and uses it as the gold standard for immigration purposes. If you feel unsafe you may ask local CDC or private lab to have a quick test on HIV antibody for you before going to the panel physician. The result should be available in several days. Since you have already passed the 3-week window the result should be accurate. There is no reason to wait.

 

[canuck78]

The panel physician is just testing the antibody of HIV and uses it as the gold standard for immigration purposes. If you feel unsafe you may ask local CDC or private lab to have a quick test on HIV antibody for you before going to the panel physician. The result should be available in several days. Since you have already passed the 3-week window the result should be accurate. There is no reason to wait.

No point rejecting the ITA. Would mention your situation to the panel physician but unless you have other medical issues most don’t get rejected for being HIV+. Unfortunate that you didn’t take antiretroviral after the stick. Hopefully your partner managed to escape infection as well if you do come out positive. Best of luck.

Assume that if you are a physician you’ve looked at the requirements for IMGs to get licensed. It always surprises me how many have not done their research and are shocked when they discover it may not be possible to get licensed unless you come from a few select countries. If you’re lucky enough to secure a residency spot you may be looking at many years before getting back to practicing independently. It is also tough to secure a job in many specialities. Wait times are due to budget issues and not due to lack of physicians to hire (in most cases).

 

[Benibenji]

The panel physician is just testing the antibody of HIV and uses it as the gold standard for immigration purposes. If you feel unsafe you may ask local CDC or private lab to have a quick test on HIV antibody for you before going to the panel physician. The result should be available in several days. Since you have already passed the 3-week window the result should be accurate. There is no reason to wait.

thank you for your response. I plan to do the test a few days prior to my medicals and possibly explain to them my situation.

 

[Benibenji]

As per the IRCC guidelines for medicals, the panel physician will only conduct rapid test and if it comes non reactive, the same will be entered in your medical report. So there is no reason for your to wait.

The details of HIV are listed in the IRCC release available at https://www.canada.ca/content/dam/ircc/migration/ircc/english/department/partner/pp/pdf/imei_hiv.pdf

It specifically states:

"A single negative result does not preclude the possibility of HIV infection, but is acceptable as an initial test for IME purposes. Post-test counselling after a negative HIV test result is recommended, but not mandatory for CIC purposes. This would include providing information on the importance of risk reduction. PPs should indicate whether they believe that there may be a high risk of a false-negative result."

For more details, you should consult the panel physician who will be doing your medicals for the purpose of immigration.

Hope this helps!

I really appreciate your response... do you think I should disclose my situation to the physician when I go for my medicals mid this month?

 

[Benibenji]

No point rejecting the ITA. Would mention your situation to the panel physician but unless you have other medical issues most don’t get rejected for being HIV+. Unfortunate that you didn’t take antiretroviral after the stick. Hopefully your partner managed to escape infection as well if you do come out positive. Best of luck.

Assume that if you are a physician you’ve looked at the requirements for IMGs to get licensed. It always surprises me how many have not done their research and are shocked when they discover it may not be possible to get licensed unless you come from a few select countries. If you’re lucky enough to secure a residency spot you may be looking at many years before getting back to practicing independently. It is also tough to secure a job in many specialities. Wait times are due to budget issues and not due to lack of physicians to hire (in most cases).

Thank you. Yes I am a physician and I am aware of the hurdles in getting residency in Canada so I am currently thinking of alternative routes.

 

[legalfalcon]

I really appreciate your response... do you think I should disclose my situation to the physician when I go for my medicals mid this month?

As an applicant you will be asked to fill in a small questionnaire and disclose any underlying illness you may have. Upon filling it out, you will be consulted by the physician and you can discuss it in detail with him. Most physicians will not go beyond the score of the examination, and as long as the test is non-reactive, they will just enter it. Others may enter the details you provide in your medical report. It will be a decision entirely on the panel physician, and since you are from the medical field, you can discuss this with the physician.