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Doctor looking after terminal AIDS patient

Feb 18, 2008

Dear Dr. Bob I am sure you have answer these kind of question many a times, but I think an answer from you will be extremely reassuring! I am a doctor currently working with patients with cancer; I have a patient with AIDS related lymphoma whom we had to do a bone marrow aspiration for. I was only assisting at the time and the procedure went smoothly. Later that day one of my colleagues noted 2 small speckles of blood on my face, I wasnt worried at first until they start painting some horrible picture about how I could have had blood in my mouth and nose and how it could have been from the patients with an extremely high viral load. I have done other procedures earlier on the day and there was no way of telling when I got blood on me. So I decided to get seen at occupational health. The consultant told me my chance is close to zero, as saliva will digest the HIV if I had small amount of blood in my mouth, which I know is inaccurate. But they are going to do the follow-up testing for 6 months. My questions are: 1. In your option, what do you think my chances are? 2. Our lab uses the Ab/Ag assays, which is 4th Generation, if I test negative in 6 weeks time, can I relax a little then? Or do I need to test out to 6 months? (Seems pretty pointless to invent new test assays if the window period we recommend still stays the same as the 1st generation.) Like you, I love being a doctor and I always put my patients need before mine, please answer this question and give me so peace of mind.

Fellow medics/pianist

Response from Dr. Frascino

Hi Fellow Medic/Pianist,

1. I agree with the occupational health consultant's assessment that your chances of acquiring HIV are essentially nonexistent. The follow-up routine HIV screening is merely precautionary.

2. I think you can relax now; however, the guidelines for routine testing following a potential occupational exposure suggest screening out to six months. I agree with the recommendation. The window-period recommendation will most likely decrease as we gain more information and data on the new testing assays.

Good luck.

Dr. Bob

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