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Occupational exposure
Apr 16, 2011

Hi Dr.,

I am a graduate student and on 2/16/11, I was doing an experiment in which I was working with HIV+ blood. I had processed the blood and separated out the mononuclear cells from the blood and discarded the RBCs and plasma in a 10% (or higher) bleach solution. After at least 5 minutes (probably 8-9), I discarded the bleach/plasma/blood solution down the sink drain. Unfortunately, some of this mixture splashed up out of the sink and hit my cheek where I have a bit of Rosacea/inflammation. I immediately notified my supervisor, washed my cheek, and went to the ER where I was started on PEP (PIs and NRTIs). I took the PIs for only one week (they were making me extremely ill and my doctor thought my risk was low enough to stop) and the NRTIs for the full course.

It has been almost 7 weeks and I have been having some neck pain.. particularly the sternocleidomastoid muscle and a bit of a sore throat. I have been monitoring myself for a fever (with none), and have had no real "flu-like" symptoms except the sore neck muscles. I am due for my 6-week testing tomorrow, but have really started to worry about this. I realize my risk is extremely low, but do you know of any cases like this that have resulted in transmission? This has begun to really cause me stress!

For what it's worth, it is likely that the patients VL was very high (as he hadn't been to an actual physician for 2 years!), though the exact number isn't known.

Response from Dr. Frascino

Hi,

Your HIV-acquisition risk is extremely remote. I would not have recommended a course of PEP for such a negligible degree of risk. Your symptoms are not worrisome for HIV acute retroviral syndrome (ARS).

Dr. Bob



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jumped from plane no parachute, now confused Part 2 (INAPPROPRIATE USE OF PEP, 2011)
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update test to "can a specialist be wrong" post (FALSE POSITIVE HIV TESTS, 2011)

  
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