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YOU DUMMY
Nov 13, 2006

I just read a recent post where a nurse got stuck by a needle working on an HIV person. she recieved PEP within 1 hour, instead of reasuring her you sent her to another website. Her risk was minimal, at least thats what you claimed, now she has unwarrented anxiety

Response from Dr. Frascino

Hello,

Dummy??? Hmmm . . . .

My job here is to offer sound scientific advice and information, not blind false reassurance. The questioner asked for "data on seroconversion after needlestick when PEP has been used." I did not send her to another Web site! I provided a medical reference paper from the Department of Health and Human Services that contains the specific data that he or she requested. (See below!)

I might also point out to you, Little Miss Know-It-All, that I, too, sustained an occupational exposure to HIV and took PEP within minutes of the exposure. However, I seroconverted to HIV positive nonetheless. PEP, even when taken quickly and correctly, is not 100% effective. There are PEP failures, including yours truly.

If you ever write to this site again, I suggest you begin with an apology.

Dr. Bob

hiv and needlestick Nov 12, 2006

Hi Dr Bob

I'm after a bit of reassurance. This week I sustained a needlestick injury from a patient with HIV when I was anaesthetising her for a caesarean section.

It was with a 21G needle that I had been using to infiltrate local anaesthetic, and it just drew blood from my finger (through gloves).

The patient had non resistant HIV was on first line anti retrovirals and had been on IV anti retrovirals for 4 hours before the procedure. I'm not sure what her viral load was, but not low enough to have a vaginal delivery. I managed to start PEP within an hour of the injury and will be taking it for 28 days. (Thank god for ondansetron and loperamide!)

Obviously you can't tell me I'm definitely going to be ok, but I'm finding it difficult to find data on seroconversion after needlestick when PEP has been used.

Thanks

Response from Dr. Frascino

Hi,

The data are indeed somewhat scarce and sometimes anecdotal. Since you are obviously medically sophisticated using the generic names ondansetron and loperamide instead of the brand names Zofran and Imodium I'd recommend you download and read the Department of Health and Human Services/Centers for Disease Control and Prevention "Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis." It's well referenced and provides data up to 2005. It can be found at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm.

Good luck!

Dr. Bob



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