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Med School Exposure
Jun 22, 2011

Dr. Frascino,

How you doing? I hope all is well. I had a question about my occupation exposure to HIV. I am a medical school student doing his rounds throughout the hospital. I came into contact with HIV+ blood. It was only on my skin for less than a few minutes. I didn't realize he was positive until after the fact. Anyway, the doctor I spoke with felt PEP was not warranted.

That was six months ago. After 26 weeks I have tested negative. Woohoo, I think.

Here is my real question. When I had to have my titers done as I entered medical school, it was found that I was unable to amount an antibody response to Hep B and measles. My question is, is it possible that I have HIV but am unable to amount an antibody response, ultimately causing me to test negative? I feel rather healthy, but did have some unusual symptoms in the past, such as lymph node swelling that never happens. I totally concur that symptoms mean nothing, but is it possible that I am infected and just not testing positive?

Thanks for your time.

Response from Dr. Frascino

Hi.

I agree with the advice you received from your doctor: The HIV-acquisition risk was essentially nonexistent (HIV can't penetrate intact skin) and PEP was not warranted.

Regarding your ability to mount specific antibody responses, was it only hepatitis B and measles vaccines that failed to induce specific antibodies or was this noted with other antigen challenges as well. Your doctor or a clinical immunologist should clarify this issue and possibly evaluate you for common variable immunodeficiency.

Good luck.

Dr. Bob



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