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Healthcare worker initially non-immune titer, now immune after needlestick
Feb 27, 2003

I work in acute dialysis and prior to begining work had baseline bloodwork completed whihc included negitive for Hep A, B, and C, and non-immune for HBsAb, concurrently I tested myself through a home-testing for HIV (which was also negative.) I am not sexually active (for past three years), no other risk factors. I did recieve a "dirty needle stick" from a low risk ERSD patient, followed protocol, bled the wound and cleaned it throughly. My concern lies with the fact that now my HBsAg is -, but my HBsaB now shows 15, immune. Why is this? My HIV test post exposure is not back yet. Is is possible I have Hep b or HIV and it is responsible for the conflicting results? Additional info includes "floaters" now present in my visual field and chronic lymph node enlargement (less than 5mm) in my neck on the left side. PLEASE ANSWER SOON, I'm ashamed to ask co-workers or physicians I work with.

Response from Dr. Dieterich

You should not be ashamed to ask for help. We all have needlestick worries and risks. However if you never received the vaccine you may have been exposed to HBV. I would recommend that you get HBcore antibody. If it is positive then you have really been exposed and if the surface antigen is negative then you are OK. After this is over get the vaccine if you still need it for both hep A and B. Good luck! DTD



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