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occupational exposure to HIV, please please please answer!! 5th try!e
Apr 14, 2012

To make a long story short, on Dec 6th 2011 I was drawing blood on an HIV positve person at work, using a butterfly needle size 23 gauge by 3/4 and somehow obtained a needlestick injury. I quickly washed my hands and headed straight for employee health where I was able to see the infectious disease Dr, who just so happened to be the Dr of the patient i was drawing blood from. She started me on a three drug pep cocktail of norvair, truvada and presista which i took for 30 days with 100% adhearance. The patient was tested for HEP B and C at the time and was negative. All of my baseline testing was negative. Unfortuneatly they fired me for this expousure and will not let me see the ID Dr any longer, so i have been on my own for testing. they have been as follows. Baseline-Negative At Sixteen days ON PEP- Negative HIV RNA by PCR At sixteen days OFF PEP (46 days from exposure) Negative HIV RNA by PCR. Six weeks from exposure- Negative HIV antibody 1/2, Negative HEP C 13 weeks and 2 days from exposure(2 months and 2 days off pep) Negative HIV antibody 1/2 All of my tests have been done by samples of blood obtained from my vein and sent to a laboratory. I know that the risk is low for occupational exposure, i think i read somewhere it was like 0.3 percent without the use of pep medication. Also I know that it was a small needle, and the patients VL at the time was 139. (one hundred and thiry nine) I think i read somewhere that the infectivity has a lot to do with the amount of the VL at the time. Wishful thinking, I don't know. I am 40 days away from having my six month test and I have been pretty much living in terror this whole time. I have refrained from having any sexual intercourse with my husband, out of fear of infecting him. I guess I have convinced myself that my six month test will be positive. I have read so much conflicting information as to when to test, the type of test to use, and of course what scares the hell out of me, is that the use of pep meds will delay seroconversion. I can not even function anymore. HIV is all i think about all day, and usually what i dream about at night. Someone please give me some hope and guidence. Why does the CDC say six months, if 99% of people test positive by 8 weeks? Is this a legal, more conservative approach to cover ones behind? God I hope thats the case. please please please, help me find some hope in this dark situation.

Response from Dr. Wohl

Your are almost certainly NOT HIV infected. First, the risk is very low from a needle stick. Second, a viral load of 139 is very low and transmission is related to the amount of virus in the infecting fluid. Third, all your tests, including the VIRAL LOAD, are negative, The PEP will not make this test undetectable once the meds have stopped. Fourth, the CDC recommendation for 6 month testing is old (2005) and the problem with the internet is you get out of date information if you are not careful. There are better tests now and the 6 month testing recommendation no longer reflects the reality of the sensitivity of newer tests.

You are not going to test positive at 6 months.

DW



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