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percentage of transmitting HIV infected blood thru a cut on hands
Sep 6, 2011

To Doctor Bob.

I am a nurse with patient newly diagnosed with HIV. Before he had this diagnosis, i happen to obtain blood samples from him to be send to laboratory for some routine tests.and by accident, some blood spilled on my cut hands. i have a very bad case of eczema on my hands, and get cut so easily. recently, i had a fever for few days and body ache, and i took antibiotic and some paracetamol to relieve it, and somehow i get a little better. but it doesnt stop me from worrying my chances of transmitting this virus. do i need to take some tests already now? or am i just panicking too much. please give me some advice. thank you.

Response from Dr. Frascino

Hello.

All occupational exposures should be reported to your occupational health division so that the incident can be documented and the exposure evaluated and treated if needed. If you had done this, you wouldn't be panicking now, as you would know exactly your level of risk and a follow-up plan of testing and/or treatment would have been instituted. As a nurse you should have a clear understanding of the policy and procedure to follow for blood-borne-pathogens exposure.

It is difficult for me to give specific advice without more information about you and the source patient and without examining you. Was the "newly diagnosed HIV patient" on antiretroviral therapy? What was his CD4 count and HIV plasma viral load? How bad is your "very bad case of eczema"? Did the source patient's fresh blood come in contact with non-intact skin? Etc., etc., etc. This is the information that would (and should) have been collected at the time of the incident.

I would advise you report this incident, even though it's after the fact. I'm assuming more than 72 hours has lapsed since the time of your exposure. Consequently post-exposure prophylaxis (PEP) would no longer be an option. Testing guidelines for occupational exposures recommend HIV-antibody testing immediately (baseline test) and at four-to-six weeks, three months and six months.

Good luck!

Dr. Bob



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