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HIV Exposure through Needlestick Injury?
Jul 7, 2011

I know my risk is extremely low, but the more reassurance I get, the better I feel. I work for a medical device reprocessing company and we collect single used devices from the operating room. I was picking up a container one day and a syringe (that should have been in the sharps container) stuck the side of my index finger. I bled and quickly washed and applied iodine solution.

Now, here are all the facts. The needle was a small 25 gauge needle that was almost completely full of clear fluid. The fact that the syringe was almost completely full makes me think it was not used. Also - the fluid was completely clear - no tint of pink/red from blood. We only pick up containers from this specific hospital once every 45 days - meaning it could be anywhere from 1 day old to 45 days old. After getting stuck I looked at the syringe and saw no visible blood, and when I pressed on the syringe only clear liquid came out - no blood. Further, this was for a day surgery section at the hospital - they have no trama and every patient is screened beforehand. They also rarely take infectious patients (they send them to the main hospital across the street).

I took truvada and azt for 2 days after the incident, but felt too ill and decided my risk was low enough to stop taking the medication. It's been 3 weeks and I have had no symptoms.

Can you please reassure me?

Response from Dr. Frascino

Hi.

All occupational exposures, or potential occupational exposures, should be reported to the occupational health division. The incident can then be appropriately evaluated and documented with a detailed history and physician examination. If needed, the source patient could be tested. A plan is then established for reassurance, monitoring or PEP as needed. Follow-up HIV testing would be arranged if indicated. If you didn't do this, I'd suggest you report the incident, even after the fact.

From the limited information provided, I would not have recommended PEP. I agree with your decision to discontinue the antiretrovirals. A single HIV-antibody test at the three-month mark, primarily to gain peace of mind, is all that's warranted.

Good luck.

Dr. Bob



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