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needle stick injury-need help
Oct 18, 2004

hi Doctor! I am sorry because I am not used to writing English. I am health care worker in rural local hospital. 6month ago, During suture of laceration wound of extremities, I was accidentally exposed(needle stick injury- surgical suture needle)- no bleeding and no scratching wound of my finger, only mild pain) The patient was 20 years old student(His last sexual contact; 6week ago from my exposure). I am very scared, so hiv test was done without PEP. i have never sexual contact after exposure. In Korea, here is no public system about PEP. **my hiv test history was... soon after needle stick injury: I; rapid hiv1,2 test :negative patient: not taken 4week after exposure: patient: rapid hiv1,2 test :negative 6week after exposure : I; rapid hiv1,2 test :negative 11 week after exposure: I; third generation elisa test for hiv1,2: negative 16 week after exposure: patient: rapid hiv1,2 test :negative third generation elisa test for hiv1,2: negative 23 week after exposure: I; third generation elisa test for hiv1,2: negative

I am very happy after my last test. But I am scared, because after needle stick injury must wait over six month in Body.com. I do have questions though: 1. Is an HIV test at 23 weeks acccurate enough to be considered CONCLUSIVE? (I believe 6 mo. is 26 weeks) Is it close enough? Do I study again after 6month? 2. Some Doctor say That one more test recommanded after 1 year in case of needle stick injury, is it true? 3. I made hiv tests only one hospital. but Some people say that hiv test must be done by several other method( as like PA or other generation Elisa)-because of false negative Do I need one more test at other hospital?

thank you.... ps) all population in south korea: 48,000,000 proven Case of Poz: about 3000 I decide retest or not by your recommand.

Response from Dr. Frascino

Hi Healthcare Worker,

Even "rural local hospitals" should have a policy and procedure in place for evaluation and treatment of occupational exposures to blood-borne illnesses, like hepatitis and HIV.

Your situation appears to be very straightforward. You and the patient are both HIV negative and no further testing is warranted. The patient's repeatedly negative HIV-1 and HIV-2 tests out to 16 weeks are definitive. Since he does not have HIV disease, he could not transmit it to you. Your repeatedly negative HIV-1 and HIV-2 tests out to 23 weeks merely corroborate this fact and reconfirm your negative status.

Stay well!

Dr. Bob



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