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Physician bitten by HIV+ patient
May 9, 2007

Hi, I am an intern with an interest in plastics so this is not my area of expertise!! I was bitten by a psychotic patient with AIDS when taking a history. Contact for about 2 seconds then a 'rip' across my forearm with enough penetration to cause me to bleed. He had no lesions in his mouth, CD4 199 and a high v/l. Took PEP straight away. What are my chances?

Dr Plastics.

Response from Dr. Frascino

Hello,

HIV transmission via human bites has been reported only rarely in the published medical literature. Being bitten by an HIV-infected person exposes non-intact skin to saliva. If the saliva is contaminated with infected blood, there is a theoretical risk that transmission could occur. Saliva not contaminated with blood would constitute a negligible exposure risk.

PEP will decrease your risk of acquiring the virus. All health care workers even interns wishing to specialize in the diseases of the rich and beautiful need to be well versed on HIV/AIDS. I suggest you review the "Updated US Public Health Services Guidelines for Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis." It can be downloaded from the CDC or HHS Web site. It also appeared in the MMWR (Morbidity and Mortality Weekly Report) September 30, 2005/Vol. 54/No RR-9.

I'm also assuming you documented your potential occupational exposure with an incident report and are following your training program's policy and procedure for evaluation and management of occupational exposure to bloodborne pathogens. If not, you should do so without delay.

Good luck, Plastics Guy,

Dr. Bob



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