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resident doctor - please consider this query
Apr 17, 2011

Dear Sir,

The work you are doing is tremendous. It provides peace to millions minds. Million thanks for your great effort. You are god figure for all of us poor people. I will surely donate for the good cause that you have began. I will not disturb you again Please help sir.

I am male doctor 28 years, never had sexual exposure: virgin) badly need your best wish karma. Please dont ignore this its tough situation for me. You answered my query on 9 Nov. 2010 under occupational risk but I have some queries. The incidence goes as follow-

I received needle stick injury around June 2006 from a unknown status patient, but could not take PEP. After getting admission to MD in may 2008 I underwent two Elisa test from two different laboratories which were negative.(almost more than 18 months after exposure)then I relieved I took counseling for this and they said HIV is not my problem at all ) Ok fine.

But when I was performing plasma ascorbic acid level in diabetes patient's (the HIV status of these patients is not known all between age group 37- 59) sample (8-10 samples) which I collected 3-4 weeks before the procedure & then centrifuged and stored in refrigerator. I performed this procedure on 18th June 2009. While performing I could not use the gloves. But I took care that I will not get in contact with serum. I used pipette with a long tip to transfer serum from one test tube to another. Few times I removed the tip of the pipette and attached new tip. But tried to hold only the topmost portion of the tip which was not in contact with serum (that is what I remember)

I used to dip the same used tip in distilled water contained in beaker (250ml) after its use to clean it and take another sample. By mistake I used the same distilled water to rinse the 2-3 test tubes. But slight(5-10ml) quantity of this distilled water fell on my fingers of left hand. After 10 - 15 min I washed my hands under the running tap water.

As far as injuries are concerned (open fresh cuts, dermatitis and wound), to the best of my knowledge I had no injuries. (I tried hard to recall about all the injuries, but 99% I think I had no injuries) I play guitar so the skin of my fingers is hard and rough. I am vaccinated to hepatitis b. to be frank I am at least sure that there was no fresh injury or any bleeding wound at the time of doing procedure. From whatever I remember about the incidence I think I have never come in contact with serum directly visible to my eye.

This procedure was actually performed on 3- 4 occasions, one on 18th june and July (2009). And all the times I could not use gloves.

Since few days I feel that if such exposure poses any risk of HIV then I am in trouble. Even this thought has disturbed me. What is my risk? Whether should I have taken PEP? Do I need any test to rule out the same? I took HIV counseling also and they people told me that her is no need to worry as I was not having any injury and if I had suffered any injury then would have remembered it. Forwarding my incidence for your expert advise. I believe in you sir please help me out

Response from Dr. Frascino

Hello,

1. Your HIV-acquisition risk is nonexistent.

2. PEP would not have been warranted.

3. HIV testing is not medically warranted.

4. I would advise you return to counseling, as your fears are completely unwarranted and highly irrational.

Dr. Bob



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