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Needlestick injury with HIV+ve patient - *SCARED N DESPERATE*
Mar 28, 2002

Dear Dr Kull, I was taking blood for a patient (unknown at that time)last Friday 22/3. I was using a vaccumtainer, the needle is double ended with one end covered with rubber that goes into the tube. When I disposed the vacuumtainer needle, I accidentally pressed the rubber end n the needle poked into my index finger, bout 1mm deep. I don't think the tip that went in contained any blood n my finger bled immediately n I squeezed the blood out again n again. I was not wearing gloves then. The patient was later tested to be HIV +ve, and I was called back after 14 hrs to start on Prophylactic medication!! I'm very worried... Please help me and advise on whether my risks are high or not...

Response from Mr. Kull

HIV transmission to healthcare workers does not commonly occur, and the CDC is aware of only 57 healthcare workers that have been infected through occupational exposures (that's quite small considering how many needlestick injuries actually happen). One source estimates a .3% risk of HIV infection after a needlestick exposure to HIV-infected blood. Factors that might increase the risk of transmission are: depth of the puncture, size and type of needle (hollow-bore needles pose a greater risk), where the puncture occurs (vein and artery punctures are greater risk), and the viral load of the host. Punctures that produce spontaneous bleeding may pose a greater risk. A person who is in very early or late-stage of HIV disease is more likely to have a higher viral load, possibly increasing the risk to the person experiencing the needlestick injury.

If your skin was punctured and there was HIV-infected blood in or on the needle, then you are at risk for infection. It's great that you started PEP. It is also important that you talk with an HIV specialist about your options for HIV screening, early treatment interventions, and psychological support as you work through this tough period. It is also crucial that you engage in safe sex activity until you have a better understanding of your HIV status.

RMK



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