Dirty needle stick

[Docgeorge]

My gf was the recepient of a dirty neddle stick. The patient, as well as she were tested for HIV and both came up negative. Her Hep C test should be comming back in a couple of days. The question is assuming the Hep C comes back clean are we in the clear?

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[southerndoc]

No. It can take up to 6 months to develop antibodies to HIV. If the patient had a recently acquired hep C, then it might not show up.

HOWEVER, while it is possible that she still has a chance of getting something despite negative test results, it is highly unlikely.

What kind of needle was she stuck with? A hollow-bore needle (e.g., IV catheter) carries a greater risk than a closed needle (e.g., suture needle).

There is only a 1:300 chance of contracting HIV from a dirty needle with a known HIV+ patient. That's the stats that I read last. I dunno what they are for the various hep viruses, but I know they are much, much more contagious. I just can't quote you numbers on the heps.

 

[womansurg]

I think Hep C is interesting. Isn't it supposed to be a risk of about 1 in 25 for seroconversion after a needle stick from a Hep C patient?

What's odd to me is, while I'm rotating at the county hospital, it seems as though every single person is Hep C positive. I had thought that it was also sexually transmitted, but I saw on a website recently that this isn't felt to be true. So, are ALL those people shooting IV drugs and sharing needles? Are people really that dumb? And is IV drug use that common? What are people shooting IV nowadays? Where can I get some? (Whoa...where did that come from....)

 

[Airborne]

I've posted previously on this topic, check out this link on SDN:

http://www.studentdoctor.net/forums/showthread.php?s=&threadid=49200

Airborne

 

[Olanzapine]

I always remember it by the rule of 3's. 0.3% for HIV, 3% for Hep C, and 30% for Hep B (if you haven't been vaccinated). Of course there is a greater risk if you were stuck with a large bore needle with a large amount of blood in it, lesser risk if you were stuck with a suturing needle that looked clean. That's good news about the HIV, your gf did the right thing about being tested herself for those diseases. They don't test the people stuck right after they get stuck to see if their infected, they actually test people to see if they previously had the disease and can therefore get out of paying for the treatment of their disease. It's a legal issue more then a medical issue. If your gf has been vaccinated for hep B, and Hep C comes back negative, you can probably rest easy. There's always a chance that the screening tests will misdiagnose, but the probability is largely in your gf's favor.

 

[womansurg]

Originally posted by Airborne
I've posted previously on this topic, check out this link on SDN:

http://www.studentdoctor.net/forums/showthread.php?s=&threadid=49200

Airborne

I remember that thread. Here is your reply. We've already talked about the rate of seroconversion; what about all my other probing questions?

Approximately 1-2% of Americans have HCV, and if one assumes a 3% chance of seroconversion, this approximates a 0.045 percent (or 1 in about 2200) chance of seroconversion for HCV for each needle stick. Is this career ending? I wouldn't know. But I can say that even IF you did seroconvert, the disease is FAR less malignant as we are led to believe. Indeed, there is a current believe that only if you have additional risk factors (ie alcohol) you'll progress to cirrhosis - Indeed, about 1/3 of chronic HCV carriers NEVER develop fibrosis.

 

[Docgeorge]

Thanks for all the help guys. Just for the record she was studk with a 16G Vaccutanor Needle.

 

[jashanley]

With regards to HIV conversion, 0.3 percent is the average. But this increases or decreases with certain risk factors: needle type, pt's viral load/Cd4, depth of penetration, visible blood on needle, etc....
6 months used to be the length of time a person had to wait for a second test, but the blood assays have improved and I believe that antibodies can be detected at an earlier time. So by 12 weeks a second test should register as positive, if she is infected.

 

[Annette]

Wouldn't a PCR test for viral load give an earlier positive result? It wouldn't be dependent on the body making antibodies.