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Blood Tests in West Africa/HIV1 vs HIV2

Nov 11, 1996

Working as an ex-pat in West Africa blood tests are a way of life due to exposure to malaria. I have had a number of blood tests and clean needles have been used in all cases. One thing I have noticed is the technicians do not wear gloves. Also after the blood test they grab some cotton wool and place it on your needle opening to inhibit the bleeding. What are the exposure risks in all three of these procedures? Is the opening produced by a needle big enough for HIV exposure to occur or does the infected blood have to get right in there through a larger opening? Also what is more infectious HIV-1 and HIV-2?

Response from Mr. Sowadsky

Thank you for your question.

First of all, if the needles that are being used are sterile needles, and are not being re-used, there is no risk of HIV transmission.

In terms of the technicians not using gloves, there are two problems I see with this. If the technician has fresh cuts, open sores, or dermatitis on their hands, and they get blood into these openings, they could become infected with HIV and other bloodborne diseases. Gloves protect the healthcare workers from getting infected with bloodborne diseases on the job. Also, gloves protect the patient from bacterial infections that may be on the technicians hands. If bacteria from the technicians hands get into the cut (from the needle) of the patient, the patient can get a bacterial infection. So when technicians don't wear gloves, they put themselves at risk for bloodborne diseases (including HIV), and they put the patient at risk for bacterial infections. By the way, IN ADDITION TO wearing gloves, the technician should ALWAYS wash their hands, to further reduce the risks of infection to both parties involved.

The HIV virus is smaller than a single cell. Therefore, what looks like a small opening to you is actually a huge opening for the HIV virus. The opening in the skin left by the needle is therefore large enough for HIV to enter the body. The HIV virus must get directly into the bloodstream in order for infection to occur. If it doesn't get into the bloodstream, the person will not become infected.

In regard to which is more infectious, HIV-1 or HIV-2, the studies I have seen state the amount of virus found in the body is generally lower for HIV-2, as compared to HIV-1. One can generally assume that HIV-2 may be less infectious. In addition, this lower amount of HIV-2 in the body may account for the longer period of time it takes for HIV-2 to lead to full-blown AIDS, as compared to HIV-1. HIV-1 takes an average of 10 years before it leads to full-blown AIDS. HIV-2 generally takes longer than 10 years to become full-blown AIDS.

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide). Rick Sowadsky MSPH CDS

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