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Needle Stick from "HIV infected person"
Jun 4, 2003

Hi DR. Bob

Well, i've read consderably more of this website than I care to. There are some really weird ppl out there...

My situation is fairly straight forward: I was involved in an altercation with a homeless person who then stabbed with a syringe and proclaimed "now you have aids too -expletive" He looked none too well himself, and unfortunately I was unable to recover the syringe but, managed to find the cap which I was told is from an insulin needle. I immediately began to bleed the wound out and disinfected it some 30mins later. I didn't notice any extra blood other than mine although there was a bit smeared all over my hand. He got me on the lower inside of my palm with what looks like a small bore needle. It then healed in 3 days without incedent. After all night in the ER and getting Hep B shots,drawing my blood, HIV meds I finally saw a rather unperturbed HIV doctor who basically said the chances are so ridiculously small that there is nothing to worry about. I've done some research on the net and the CDC states that out of 16000 confirmed hiv needlesticks only .3 have gone on to become HIV+.

2 questions: 1. how do you feel about this in your personal opinion? And do you think the CDC stats are reliable? 2: they put me on 1 month Combovir and Crixivan which are making me ill - cold sores, queazyness, heartburn, fatigue. Does this regimen really have any effect on any virus that may have been injected into me?

appreciated

Response from Dr. Frascino

Hi,

The CDC has been closely monitoring confirmed HIV-positive needle stick exposures for many years, and the statistics you stated appear to be holding steady. Chances of seroconverting from a significant needlestick from a confirmed HIV-positive source are one in 300-400 per episode. Your risk is less, because you are not sure if Mr. Loony Tunes with the insulin needle was really HIV-positive or not.

Post-exposure Prophylaxis has been shown to decrease the risk of seroconversion, if started within 72 hours of the exposure. Often, only a 2-drug regimen (Combivir) is used. The Crixivan component (protease inhibitor) is usually added only when the exposure is severe. If you cant tolerate all 3 meds, talk to the HIV doctor about using just Combivir. You can review the CDC recommendations in Morbidity and Mortality Weekly Report (MMWR) September 25, 1998/Vol 47/No. RR-17.

Good luck!

Dr. Bob



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