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fellow doctor needs help
Mar 10, 2009

hey Dr Bob, I am a third year cardiology fellow. 4 weeks back I had a needle stick injury. Unfortunately, the patient was HIV positive. since that day i am not able to function appropriately!! I did some literature search and got a NAT HIV test and Standard antibody testing at the 4 weeks post exposure. Both tests turned to be OK. do you think i am safe now?? please reply if u can

Response from Dr. Frascino

Hi,

I'm amazed you've made it through medical school, internship, residency and three years of cardiology and still have so little knowledge concerning occupational exposures to bloodborne pathogens! This is a deficiency in your training!

Are you safe after a four-week NAT and HIV-antibody test? No. I suggest you download and read a copy of the "Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Post-exposure Prophylaxis." (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm)

Did you report your exposure to occupational health? Did you get evaluated by an HIV specialist to ascertain if PEP was warranted? Regarding HIV testing following an occupational exposure to HIV, the guidelines recommend HIV-antibody testing at baseline, 6 weeks, 12 weeks and 6 months from the exposure date. Certainly your negative tests at four weeks are encouraging, but not yet definitive.

Good luck and remember to study up on occupational exposures to bloodborne diseases. It just may save your life someday. Also make sure you share the information with your team of fellows, residents, interns, medical students and perhaps even your attendings!

Dr. Bob



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