Needle stick but patient was HIV negative
Aug 16, 2013
I was starting an IV with a 20 gauge and the needle did not retract all the way and it pricked my finger through my glove. The patient was hepatitis c postive, which I already knew from history. Patient was tested for HIV and was negative. Patient had also been immunized against Hepatitis B. I did not qualify for PEP. My concern is that I am breastfeeding. The nurse at my pediatrician said I could resume breastfeeding if the patient tested negative, and I spoke to a physician at the PEPline who also said I could breastfeed. What if the patient was in the window period? Why was I not offered PEP if the patient could have been in the window period? I read on the PEP site that it's not necessary to determine if source person is in the window period and that to date no source has transmitted HIV to a healthcare worker in the U.S. during the window period. Why is that? Is it safe for me to breastfeed?
Response from Mr. Cordova
It is likely that they tested the patient using a PCR DNA test and/or an antigen test. Both are capable of detecting an infection early than the 90 day window, and can in fact pick up an infection as recent as a few days.
I'm not sure what sources you are looking at, but again, in situations like this, they would do more than antibody testing because it is necessary to know if someone is infected, including individuals in the window period.
Bottom line: You are safe to breast-feed. If you are still concerned then I would suggest using a breast pump until you reach the 90 day mark. The virus is very fragile and would not survive any length of time outside of the human body. Pumping your breast milk ahead of time and putting it in the fridge would deactivate any virus present. At the 90 day mark you could test for a conclusive result. If this is the route you choose to take I am confident that your test result will be negative. Good luck.
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