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Risk of Transmission
Apr 29, 2012

Hi there. I am a healthy 25 year old RN. Last week I was removing a peripheral Iv catheter from an HIV+ patient with a viral load of 170,000 and a CD4 count of 2. When I removed the catheter, there appeared to be a drop of bloody/serosanginous material that flicked into the air and I have no idea where it landed. I guess if I didn't feel the drop land on me, then it didn't. But if it did hit my eye, mouth or skin am I at high risk of infection? Thank your for your help

Response from Dr. McGowan

Hello and thank you for your care of people living with HIV, you are on the front lines of dealing with this epidemic.

In the hierarchy of risk, a mucous membrane exposure (as opposed to a hollow bore or solid bore needle exposure that punctured the skin), is relatively low risk. The risk for HIV transmission from a needle stick is 0.3% (which is 1 in 300 exposures will lead to an infection) and for a mucous memebrane exposure is 0.09% (which is 1 in 1100 exposures). The height of the viral load in the fluid may increase the risk, but even with a high volume exposure the risk may be 1 in 200 exposures. So the risk is small even if you had been splashed.

A contact on intact skin would have no risk of infection at all.

Best, Joe



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