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!

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