Are we not concerned about the window period for HIV testing before surgery?

Under normal circumstances, when testing for HIV before surgery, the window period should be taken into consideration. Using highly sensitive testing methods can help reduce associated risks. In special cases, a comprehensive assessment based on medical history is required. If there are concerns, it is recommended to seek medical advice in advance. The detailed analysis is as follows:

If fourth-generation HIV testing (which detects both antigens and antibodies) is used prior to surgery, the window period can be shortened to approximately 4 weeks, which in most cases covers potential infection risks before the procedure. For individuals without clear high-risk behaviors and without abnormal symptoms before surgery, using this type of test results in a low probability of missing an infection during the window period, effectively ruling out HIV infection, so excessive concern about the window period is generally unnecessary.

If third-generation testing (antibody-only detection) is used before surgery, or if the individual engaged in clearly defined high-risk behavior (such as unprotected sex or needle sharing) within 4 weeks before testing, they may still be within the window period, posing a risk of false-negative results. In such cases, patients should honestly inform their doctors about their high-risk history. The physician will then make a clinical judgment on whether surgery should be postponed or whether retesting after the window period is needed postoperatively, to avoid missed diagnoses due to the window period.

When undergoing preoperative HIV testing, patients should truthfully inform their doctors of recent activities and medical history. Those with a history of high-risk exposure are advised to proactively request more sensitive testing methods. If concerns about the window period persist after surgery, follow-up testing can be performed after the appropriate interval to ensure accurate results.