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please help me
Jan 14, 2004

i am a nurse (dialysis) i had an irritation on my hand . i got splashed on my hands during the disconnection of the reinfused line.what got into my cracked skin was a combination of saline and pt's blood . i went to my supervisor for an incident report but they said it is not an exposure . my patient at that time was full blown aids patient . so i took their words but in the back of my mind i will go ahead and get tested on my regular physical exam which i had my physical exam 2 months after the exposure i had added or requested to have the hiv test which came negative then thid year i had another physical exam and i requested to have the hiv test it came back reactive please give me an advise i am so worried and anxious i had been crying please help me i am waiting for the viral load result and the cd4 can i go back to my employer the exposure was may 2002 my first hiv test was july 2003 neg and recent was dec 2003 which is reactive

Response from Dr. Frascino

Hello,

I'm very sorry to hear about your recent positive HIV test.

I would suggest several things. First, are you seeing an HIV/AIDS specialist? If not, you need to consult one as soon as possible. The HIV/AIDS specialist will take a more detailed history of your possible occupational exposure and reconfirm your test results. Laboratory tests are now available to determine whether an HIV infection has occurred very recently or been present for some time ("de-tuned ELISA" test).

Next, you reported the potential exposure to your supervisor, which is certainly the right thing to do. Getting HIV-contaminated blood on "cracked skin" during dialysis could indeed constitute an occupational exposure. There should at least be a record that you reported this to your supervisor, even if he/she then felt it was not a significant exposure. It would be somewhat unusual for an exposure in May 2002 to still have a negative antibody test result in July. So this will need to be investigated further. Your HIV/AIDS specialist should be able to help you file the appropriate worker's compensation case forms, if necessary. Also, if push comes to shove, viral strain typing may be available to see if both you and the dialysis patient have identical or similar strains of HIV. At any rate, your first stop should be a thorough evaluation by a competent and compassionate HIV/AIDS specialist. If you need a referral, check the American Academy of HIV Medicine website, www.aahivm.org, for a list of certified specialists in your area.

We are here, if you have additional questions or need additional help.

Dr. Bob



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