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splash on face
Jan 9, 2007

Dear Dr. Frascino

I am so sorry for bothering you with such a stupid question. I am a healthcare worker and about a week ago while anesthesizing an open wound of a patient with positive HIV status, got sprayed with the lidocaine injection. I was not wearing any goggles (shame on me!). To my understanding I did not get sprayed in the eye and only on my cheeks. I washed my cheeks with soap and water (not eyes, since I did not feel anything in them) 1-2 min after the incident and went to employee health department. I insisted on taking PEP and am currently on combivir bid. I mostly got sprayed with lidocaine but am so freaked out since the needle was contaminated. I know that I am acting irrationally. I am ashamed and embarrassed of myself for acting in such way. I was offered a PCR test, but am scared of the high false positive results. What are my risks? Thank you for your response. You are a great human being.

Response from Dr. Frascino

Hello,

Your HIV risk from getting sprayed on the face with lidocaine from a syringe used on an HIV-positive patient is essentially nonexistent. I would not have recommended PEP.

PCR testing would not be recommended in your situation. Not only is there the potential problem of false-positives, but also false-negatives, because you are on antiretroviral drugs, which could theoretically suppress viral load to undetectable levels.

Assuming the skin on your face was intact and you didn't get any of the spray into your eyes, I would advise stopping PEP and then just have routine HIV tests per the occupational-exposure guidelines. (See link below.)

Good luck.

Dr. Bob

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a.1.htm



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