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HIV Transmission from a Nail Scratch

Oct 14, 2003

I was working with an AIDS patient (very high viral load-->750,000) and I was helping him to sit upright on his bed and he thought he would fall--so he reached out for my arm and scratched me with his fingernails--under which I looked under and could see no visible bodily fluids. I washed my arm quickly and cleaned with Bedadine. I could only see on my arm a very small scratch--red line half an inch--I don't know how deep the scratch went but I could'nt see any blood from my arm. the infectious disease team said I had nothing to worry about but am still concerned. What do you consider my risk to be? The doctors did not recommed Cobivir -- but I am taking anyway as a precaution.

Response from Dr. Frascino


What do I consider your risk to be? That's easy nonexistent.

What would I recommend? That's easy as well. Stop taking Combivir (not "cobivir," by the way). You have no risk of HIV transmission, but you do have a risk of drug side effects and toxicities from Combivir. Finally, I agree with the infectious diseases team ("nothing to worry about"). I also agree with their recommendation that you should not take PEP. You are not taking a "precaution;" you are taking a risk!

We really do know what we are talking about, and whoever prescribed the PEP for you should not have done so.

Dr. Bob

Advice from a previously worried well
Thanks Dr. Bob, I will hit a homerun for you

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