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HIV+ blood on two day old cut
Jul 29, 2009
Hello.
I am a Police Officer who came into contact with HIV+ blood on duty. Long story short is that I was searching a person who had a cut on their hand. Their cut was at least 1hr old but was still oozing and was not dry. During this process I inadvertantly touched my forearm to his cut and got a spot of blood on my forearm. The spot was approximatley the size of a quarter, just a bit bigger. The blood was not running down my arm and was more of a smudge, but was still enough to see me and scare me. Approximatley 5 minutes later another officer releived me. I washed my forearm with antibacterial soap and water for 10 to 20 seconds. When rinsing off my forearm I saw a cut on my wrist that the blood/water/soap mixture may have washed accross. The cut was about 1.5 days old and approximatley 1/4 inch long. I don't remember the cut ever bleeding for very long when I got it but it must've. The point is that it stopped on its own and I never treated it. The cut had part of a scab on it but it seemed like some of the scab had rubbed off. My MD referred me to an infectious diseases MD, who strongly suggested PEP. I am now on PEP (Truvada + Kaletra) and took first dose 50 - 60 hrs post exposure.
I am confused by the plethera of info about open cuts and what constitutes an open cut. 1. Would my wound be considered an open cut? 2. Would the soap and water mixture help to kill HIV before it ran into the cut?
I'm sorry for the long question. I'm sure that you get many of the same types over and over. I am really scared. Thanks.
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Response from Dr. Frascino

Hello Police Officer,
I strongly disagree with the advice you received from the infectious disease MD you consulted. Based on the information you provided PEP is not recommended.
Addressing your specific questions:
1. No.
2. It would certainly dilute any infectious agent. Also, HIV does not live very long outside the body. The chance you got enough fresh HIV-tainted blood into your 1.5-day-old partially scabbed cut from a blood/water/soap mixture washing across the healing wound is nonexistent.
My advice would be to stop PEP. If you remain worried about this incident, get a single HIV-antibody test at the three-month mark. The results will undoubtedly be negative. You can also consult an HIV specialist for a second opinion. I'm confident any experienced competent HIV specialist would concur with my recommendations.
Don't worry. You're fine, OK?
Dr. Bob
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