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What are my chances of having HIV

Jan 17, 2010

On 12/17/2010 I had a needle stick on my finger.I am a nurse at a clinic and I was going to demo for a patient how to use insulin and accidentally got stuck with a needle someone left without a cap in the insulin demo kit.We were using the same needles time and time again for demo. I was told that the needle was clean since we are not suppose to use them on patients, but I am concerned because it did not have a cap and when I reached into the insulin demo kit box I got stuck by the needle. I was breastfeeding my 6 month daughter and I stopped because I am scare I might have contracted HIV. I am aware the risk is minute but I am scared of putting her at any risk no matter how small. I had a needle stick in 2005 from a needle that was placed carelessly in a sharps container, I developed Hep C antibodies. I was tested for Hep C PCR and was negative and negative for RIBA. I was told by one doctor I recovered from an acute infection and by another doctor that it was a false positive. At that time it took 12 months for me to develop the antibodies. I'm not sure why it took so long. I think that it was related to my ANA being 1280 and DS DNA 15 without any other symptoms (the rheumatologist told me he cannot diagnose me as having lupus because all my other labs are normal and I have no symptoms he thinks ANA and DS DNA is high because of the hep C antibodies) or why the antibodies took so long to develop. I wanted to continue to breastfeed y daughter if my 3 month HIV antibody test came back negative but I am worried that it could take me 12 months to make antibodies if I am infected with HIV since it took 12 months to develope Hep C antibodies. I am very confused and at first my employer did not want to test me since they considered the needle to be "clean". I had to insist my case be treated as a needle stick incident since I could not be sure the needle had not been used on someone. I am very worried and I wish I could continue to breast feed my daughter. I tried 10 yrs to have a baby and now I can't even enjoy that. Any advice would be appreciated. Should I do an antigen test, pool test or PCR? Thank you

Response from Dr. Frascino


Your history is a bit unclear, due to the confusion over your past laboratory tests. Regarding hepatitis C, if you had an undetectable hepatitis C PCR and negative RIBA, I do not believe you contracted the virus. Why were you still testing for hepatitis C antibodies out to 12 months following your occupational needle stick? This most likely is a false positive (or related to a subsequent exposure). Was that test followed up with any additional studies?

Your rheumatological studies are also somewhat confusing; however, I do not believe you have a problem with delayed antibody production.

Routine HIV screening following an occupational exposure involves HIV-antibody testing immediately and at six weeks, three months and six months. If your rheumatologist feels you have delayed antibody production (which I strongly doubt), you could get a qualitative HIV PCR DNA test. The test is not used for routine diagnostic screening; however, it can be useful to help sort HIV status when HIV-antibody studies are unclear or in doubt. HIV PCR DNA does not rely on anti-HIV antibodies, but rather assays for a piece of the virus's genetic material.

I see no reason to discontinue breastfeeding, as your HIV-acquisition risk is beyond remote.

Good luck.

Dr. Bob

6th TRY: not so intact skin (and probably my mind now)
I have some problem with my work

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