transmission during window period
Jan 25, 2013
Hi Dr. Young, First, thank you for doing this. Here is my story: 3rd year medical student, got stuck twice by two separate suture needles exposed to two separate patients during surgery clerkship. Each time, no visible bleeding but a microdot of red spot can be seen at the site of puncture through double gloves. Both the patients and I got tested right away and the patients are all negative for HIV, Hep B&C etc. I was also negative and no prophylaxis HARRT taken. I know that rate of HIV transmission is 0.3% but what is the chance of transmission during window period? That is the patient is indeed HIV positive but happen to be during window period when he/she was tested when I stick myself. I have yet to do my follow up exposure testing at 3 month and 6 month. Part of reason is fear of the test being positive. Now every time i get sick, i get paranoia of being HIV+. Are the chances quite low that don't bother with retesting or should I get tested again?
Response from Dr. Wohl
Dr. Young has punted this one to our forum. It is theoretically possible that if the source patient(s) were in the window period (that is the time between infection and detection of HIV antibodies) that they could be infectious. If your hospital only did HIV antibody testing during the window period, they would miss infection.
But, suture needles are thought to be very unlikely to be able to transmit HIV (as opposed to hollow needles. So, add the exceeding low probability of infection from a needle stick, multiplied by the low odds that either of these patients had recent HIV infection, and further times that by the infinitesimal risk of HIV from a suture needle and you get a number very close to zero. Welcome to medicine.
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