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Urgent: Dog bit me after biting my HIV pos partner
Sep 16, 2009

***Apologies for the repeated submission -- I keep getting an error message from my other email address, so I am resubmitting on this address to try and insure my question is submitted. Thank you.***

Dear Dr. Bob,

I have an "animal hiv question" that is a bit urgent. I have read through your section on "animal exposure" (interesting reading!) but could not find anything similar. My situation -- My partner is HIV positive. Our dog, who we both love very much, is ill with a brain tumor. A week ago, he went into seizures. When he came out of the seizure, our dog bit my partner in the hand. It was a quick-snap puncture wound -- I saw it happen. His wound didn't start bleeding until about 15 or 20 seconds after the bite, so I don't think there was substantial (or even visible) blood in our dog's mouth or on his teeth. I went to help my partner clean his wound in the bathroom, and then about 5 minutes later, I went back to try and help our dog. He then snapped me in the hand. Not extremely deep, but it broke the skin pretty substantially. It bled quite a lot. There was a five minute gap between the two bites. The dog was salivating heavily during this incident. We went to the E.R. to have the bites treated, and later to our own doctor as well. Both knew that my partner was HIV positive. We live in San Francisco, and were at UCSF for both E.R. and our physician, so both should know a thing or two about HIV/AIDS. I asked both the E.R. doc and my doctor whether I should have PEP, and both definitively said no, the exposure would have been insignificant and did not warrant PEP. I am now greatly regretting I did not insist on PEP. I do not understand why this would be any different from a hospital needle stick, for example. I do understand that the 5 minutes between the two bites could be significant, and I also have been told that the saliva in the dog's mouth would have diffused or diluted the virus. And also the fact there was probably not blood in his mouth. But I am still freaked out. It is all so sad -- our dog is probably going to have to be euthanized in the next few days because the seizures are becoming more constant, and that alone is so devastating. And now I am afraid that I have been infected, and should have had PEP. Please let me know what you feel the risk would have been. I have tried to include as many details as possible. My partner is not yet on treatment. His TCell count is 700, and his viral load is only approximately 5,000 (five thousand.) Finally, since I have passed the 72 hour mark, (and am now at a week) would it do any good to do PEP now? How would this risk compare to, for comparison, unprotected oral or anal sex? Thank you so much. I am freaking out.

Response from Dr. Frascino

Hi,

I'm sorry to hear about your pooch's health problems. Regarding HIV transmission, I concur completely with both your doc and the ER physician: Your HIV-acquisition risk is nonexistent and PEP was definitely not warranted. No way. No how! In fact, HIV testing would not even be recommended! There is no comparison to unprotected oral sex (low risk) or unprotected anal sex (high risk), because your dog bite is a no-risk situation. I'm sure your stress and anxiety is heightened by the imminent loss of your beloved canine. Don't compound those emotions with completely unwarranted HIV fears, OK?

Be well.

Dr. Bob



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