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NURSE need help about her occupational exposures to HIV
Aug 17, 2008

Thanks you doctor for taking time to read my message , i know thats you are very busy , because , not people from united- states who want your answer but all people around the world. I am a nurse from albania , i work in E .N .T service , during an act of caring for a patient who had HIV without treatment , , i had received in my face a spit , so in my eyes which were oppened and my mouth , a spit contained visible blood because the patient had infection in his angina,which cause bleeding in his mouth, so i had splash of blood mixed with saliva in my eyes which were oppened and my mouth from patient who had aids , i have read lot of articl near my case but i want to know from you doctor if my risk is high or low or nonexistent ?please doctor answer me in my hospital we dont have a doctor whom we asked about occupational exposures to HIV

Response from Dr. Frascino

Hello Nurse from Albania,

Fresh blood (or saliva-containing fresh blood) from an HIV-positive patient that gets into your eyes and mouth would constitute an occupational exposure to HIV. I cannot really quantitate the risk, as there are many factors to be considered, such as viral strain, viral load, quantity of blood that came into contact with your mucous membranes, etc. The level of occupational risk is not as important as just realizing that it is a risk. At this point, assuming more than 72 hours have lapsed since the exposure and thereby ruling out consideration of PEP (post-exposure prophylaxis), your only option is to document the occupational exposure with an incident report and get a baseline HIV-antibody test. You will then need follow-up HIV-antibody tests at the three- and six-month marks (from the date of exposure). The statistical odds are very much in your favor that you did not contract HIV from this exposure, but testing is warranted.

You can download a copy of the "Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis" at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm.

Good luck.

Dr. Bob



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