|Medical student blood splash (droplets?) to eye from HCV/HIV positive patient during orthopedic procedure
Apr 23, 2010
I am a medical student who had a blood splash to one eye (at least one droplet) from a splash caused by the saw during an orthopedic surgery. I was watching the surgery from about 5 feet away when the droplet traveled to me eye. The patient had a HCV viral load of 1.4 or 1.7 million and tested negative for HIV (rapid test). The physician ordered a viral load for HIV as well and that came back as *below the threshold* but detectable (which I honestly do not understand). I started the three regimen PEP (days later ... I know it should have been immediately but the hiv viral load came back late since the wrong test was placed the first time). I tested negative for HIV initially and again at 1 month and three months and 5 months. My liver panel came back slightly elevated at 3 months (but the blood was partially hemolyzed which I know causes slightly elevated results), so at 5 months I had a HCV RNA test and was negative (undetectable).
Now I am approaching the one year mark and am going to go for more testing (since I have read of at least one case where infection was not detectable for 12 months. I will go for an HIV test (ELISA) and I am unsure what test to perform for conclusive results regarding the HCV? I have been told my HCV RNA is definitive, and I do not have HCV after receiving my results at five months, but I am very concerned and need to be 100% sure. Additionally, I am asking your opinion on how nervous I should be in general. The last year has been very difficult since I have been a ball of nerves and my fiancé thinks I am over-reacting, but I want to be sure of all results before placing her at any risk at all. I understand I should be able to answer these questions myself but find it difficult to think clearly being as nervous as I am. Thank you for your time and for all the other questions you have answered since these have helped keep me somewhat sane over the last year.
Response from Dr. McGovern
Your HCV RNA tests are definitive. No further testing is required.
It is understandable that you have been "a bundle of nerves", but it is now time to let go and celebrate. You were never at high risk from the start. You have been tested adequately. There is no need to test at 12 months whatsoever. Prolonged testing for HIV is only indicated if a person has a definite diagnosis of acute HCV infection.
Congrats on your upcoming marriage...
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