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Dr. Bob, Please help a Highway Patrolman

Nov 13, 2003

Dr. Bob, I am a highway patrolman in eastern South Carolina. Recently I was called to an accident. One of my best friends hit a curb at 110 and wrapped his car around a tree. Well, When I got to the scene, the car was burning, so I tried to get him out. I had break through the left rear door with hands and pry it open. Well, he was really contorted and I had to push up the dash to get him out. When I did this, I impaled my hand on a shard of glass. I then pulled him out. The problem is, my friend was a gay man living with HIV and I got his blood all over me. I knew this at the time, but with the car on fire and him hurt so badly I really didn't care. I got tested at three months and came out negative. I thought I was seroconverting two weeks afterwards. If I was seroconverting would my test show it up? I'm fixing to get tested again at 6 months, but I am worried I have an opportunistic infection. Is that possible after three months? I have Eye floaters and night sweats, and I use to be 6'2', 219 lbs, now I am down to 200. If I was suffering all this before I got tested, my test would be accurate if these were HIV related symptoms right? Thanks. I really admire you. I you are ever in SC and get a ticket, just tell them you know Trooper XXXXXXX.

Response from Dr. Frascino

Hello Highway Patrolman,

Your heroic efforts on behalf of your friend show not only profound courage, but also rare compassion and true altruism. Your HIV risk is related to possibly getting HIV-infected blood into your bloodstream through your cut. The probability of HIV transmission, if this did occur, is estimated to be 0.4%. The degree of risk would be related to many factors amount of blood that actually got into your wound, the HIV viral load in your friend's blood at the time of the exposure, etc.

Your negative HIV test at 3 months is extremely encouraging. The CDC does recommend repeat testing at 6 months for very significant exposures -- such as anal or vaginal receptive intercourse with a partner confirmed to be HIV-positive. If you feel you got a significant amount of your friend's blood directly into your open wound, then repeating your HIV test at 6 months could be considered based on these CDC guidelines.

Now what about your symptoms? An opportunistic infection would essentially be impossible, as your immune system would have to be significantly "deficient" for this to occur. With untreated HIV disease, this generally takes about 10 years. Your floaters are most likely normal. Your weight loss and sweats could be due to stress and anxiety over this whole incident.

My opinion is that with your negative 3-month test, you have very little to worry about as far as HIV is concerned. If your symptoms continue to be bothersome, have your general medical doctor check you over. There's an excellent chance your symptoms will magically disappear when you see the negative results of your 6-month HIV test.

I'll take you up on that offer of help, if I ever do get a ticket while driving in SC.

Good luck. Stay well.

Dr. Bob



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