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A worried doctor
Sep 30, 2008

While on night duty, I was asked to cannulate a patient, who was inpatient for management of hepatic encephalopathy due to chronic excessive alcohol intake. I do not know about her HIV/HCV/HBV status as I did not check in her notes. She was emaciated, however her encephalopathy was probably improving. I was not informed by the nursing staff about any infection risk such as HBV/HCV/HIV.

I tried to cannulate and I had patient's blood on my gloves. I am not 100% sure but it's likely that I did scratch my left post auricular area while wearing those gloves. That area was itchy for few weeks (on & off) and I could feel some uneven skin there. It was very likely due to either shave or use of spectacles. No active bleeding, but I did notice some serous fuid oozing from that area in the past.

Anyways after the possible touching with gloves (I honestly can't remember exactly as it was I think 3AM and I focused a lot on patient's difficult venous access), I wiped the area with alcohol strip and no blood was noted on the strip.

As I do not know the patient's infectious disease status & I do not remember her name, so can not check her results now, would you advise any HIV/HCV/HBV testing beyond 6 months after the episode? I am planning to get checked for HIV/HCV and HBV upto 6 months, but I need advice if any further testing is indicated beyond 6 months. I received Hep. B vaccination in the past and then had a booster in 2004. My Anti HBV antibodies were >100 in 2004 implying good vaccine response.

Thanks for your help.

Response from Dr. McGovern

I would only recommend testing out to six months as recommended by your employee health service. You should always review any kind of exposure with EHS for proper guidance.



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