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Doc, scared hcw here, pls hlp!?
Jul 19, 2008

Hi Doc,

Confirmed needle stick exposure into right thigh, with hollow bore needle and confirmed source patient. I did opt out of pep - I know, but I tend to tolerate drugs poorly. CBC and WBC within normal ranges, but a cpl of enlarge nodes in right groin (hence local). Very fatigued (stress(?)).

I do have, however, ag/ab 1/2 CMIA tests at 0, 6, 12 and 17 weeks. I also have a Proviral DNA PCR at 15 w; neither env, ltr, pol, nor gag was detected.

I live in Europe and the docs here say everything from 8 weeks I'm fine to not fine until 6 months. So utterly and extremely confusing!

What say you Doc? What are my chances? Pls help!

Response from Dr. Frascino

Hi,

You definitely had an occupational HIV exposure. The average risk for HIV transmission after a percutaneous exposure to HIV-infected blood is estimated to be 0.3%. PEP would certainly be recommended in this situation.

Your negative HIV tests out to 17 weeks, including a negative proviral DNA PCR at 15 weeks, are extremely encouraging. The recommendations for testing here in the U.S. would advise one additional follow-up HIV-antibody test at the six-month mark. You can download a complete text of the updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm.

What are your chances? I'd rate them as excellent!

Good luck.

Dr. Bob



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