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Scared I have HIV, After occupational exposure. Please help!!
Jan 21, 2014

First, thank you a million times for all of your hard work and compassion. I am writing to you with great anxiety that has plagued my life for the last 6 months. I am a trauma nurse who had a needle stick exposure from an HIV positive male. I will spare the details of the how, why etc. and instead give you the facts. It was after drawing approx. 9 tubes of blood from his vein. Needle size was 21 Gage butterfly needle. Source patient was tested and Negative for HEP C. He is a known positive patient that has frequently been in our hospital. Viral load at time of exposure was five hundred and forty six copies (546). I saw infection control and swallowed my first pills consisting of Norvair, presista and kaletra. This infectious disease DR. is the doctor of the source patient. So we are aware of potential resistance, previous VL, and T Cell count. approx. 4 days into pep, I could not take the side effects form the kaletra. I literally laid on the bathroom floor for 4 days. I spoke with the dr. who switched the meds to norvair, presista, and truvada. This worked better and I finished 30 days of pep. At 16 days off pep, I had an qualitative RNA by PCR which returned undectable down to 20 copies. At 6 weeks post exposure, Negative HIV 1/2 antibody screen. At 3 months post exposure, Negative HIV 1/2 antibody screen. At six months form exposure (five months off pep) Negative hiv 1/2 antibody screen. I have not seen the infectious disease dr since the exposure happened. Employee health has been ordering my tests. I don't know if this is not conclusive since I have taken pep. My husband and I want to have a second child, but I am paralyzed with fear that Ill get pregnant, have the hiv antibody screen they do in pregnancy and its going to be positive. The last thing that I want to do is put my husband at risk, let alone the health of a innocent baby. Please give me some guidance. This has taken a huge mental toll on me, to the point where I have been consistently going to therapy to help with the anxiety, depression and fear. Please provide your advice. thank you in advance.

Response from Dr. Wohl

Your testing is conclusive, you are HIV negative. As you know, the risk of HIV transmission from a needle stick is low, especially when the source patient has a low viral load.

Your tests are clear and I do not see any reason to be concerned about being a risk to other.

Just a note, the selection of Kaletra plus Prezista plus Norvir is bizarre. I am trying to imagine a reason why this would be selected and cannot. I suspect a mistake was made and then corrected when Truvada was substituted for Kaletra.

DW



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