Dr Frascino, I have a similar question and a surgical resident, today I was in the OR for almost 8 hrs with a trauma pt, just after we started I felt a wet area over the skin on one of my legs, because I was assiting I did not pay much attention to it (my mistake) by the end of the surgery I realized I had a big blood stain on my scrub tha went through the fabric and was lying over my skin exposed over my skin for over 8 hrs. When I removed the scrubs the blood was dry already and had some clots on it. I did not filled and incident report, now if I fill the report tomorrow It will be more than 24 hrs after the incident. My question is if my prolonged expousure put me at higher risk of HIV infection and if my pt turn to be HIV positive can HAART could be started 24 hrs or more after expousure? Thx

Hello,

Prolonged exposure could theoretically increase the risk of HIV transmission.

Post-exposure prophylaxis (PEP) should be started as soon as possible and no later than 72 hours after an exposure. I would suggest you report the incident immediately so that it can be documented, evaluated and, if necessary, treated. You should also thoroughly review the guidelines for occupational exposures at your institution and make sure your coworkers are aware of the guidelines as well.

Good luck.

Dr. Bob