PEP after known HIV+ splash in eyes

Question

Hi there, I work in a hospital and I recently have had a very minute amount of HIV+ blood squirt into my eye. Im not even sure if it actually went in. All i know is that it was so small to the point that my eye didnt even water or get irritated. Anyways, The doctors told me its a small risk but since the source is a known HIV+ and is very ill, they put me on truvada and isentress for 30 days. I went on the drugs within 12 hours. I just want to know how bad my risk is. Im freaking out and I dont know what to do. I seem to be tolerating the drugs well but i do feel out of it. I just want to know if i was right to go on the drugs, and what my outlook looks like. thanks in advance.

Answer

Hi and thanks for posting.

With a known HIV+ source and ill (perhaps implying having detectable viremia), and with the knowledge that ocular exposures can (however rarely) result in HIV infection, I think that PEP is reasonable. It does sound like your exposure was quite small, and therefore of lower risk.

Overall, the published risks of HIV infection following mucous membrane exposure is estimated to be about 0.09% (or about 1 in 1000). PEP is clearly believed to reduce risk much further, though it's hard to put a number on this. From AVERT.org, "a South African study of 480 rape survivors taking a 6-week course of zidovudine and lamivudine, only one woman became HIV-positive. Another study looked at 2,000 non-occupational exposures to HIV from four countries (Australia, France, Switzerland, and the United States). Out of 350 people treated with PEP who reported being exposed to HIV-infected sources, none became infected as a result of PEP failure."

I hope that helps.
BY