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Post-Exposure Prophylaxis, Occupational Exposure
Dec 10, 2010

Hi Dr Frascino, I am a medical resident and today suffered an occupational injury from an AIDS patient. I was placing a 20G IV when the patient jumped and it stuck my finger. The injury wasn't very deep, but I had a bit of blood from the puncture site when the glove came off, I washed it immediately with soap and water, and called our hotline and took my first dose of PEP (Truvada + boosted Reyataz) within 2 hours. I am continuing this diligently for 28 days, but I am honestly freaking out about this day and night, losing sleep. I have a wife and a child, and I can't help but worry about what will happen to them should I seroconvert. I want to know whether you have any data on whether PEP provides any additional protection beyond the 0.3% risk that I keep hearing? Please let me know what you think my chances are of getting HIV.

Response from Dr. Frascino

Hi,

Yes, PEP further reduces your HIV-acquisition risk; however, we can't say by exactly how much because there are many confounding variables, including viral strain, viral load, whether the source patient was on antiretrovirals, time to your first dose of PEP, exact PEP regimen, your immune integrity, etc. At this point you are doing everything you can. Freaking out will not help nor will it change the ultimate outcome. The statistical odds are all in your favor. As you are a medical resident, I suggest you review the CDC's formal guidelines for occupational HIV exposures and treatment. The document can be downloaded at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm. You should find the information reassuring.

Good luck.

Dr. Bob



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