HIV incident

[Markus1]

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I am in need for some assistance regarding a medical incident.

A friend of mine is a dental hygienist who recently was stuck by in instrument that is placed in the patient’s mouth to measure the depth of cavity. The instrument is not very sharp but with minimal force it can puncture the skin. The patient had some lacerations and ulcers in his mouth which maybe indicative of HIV infection but the patient denied any disease. In short, the instrument was originally used on the patient and was left unused for approximately 20 minutes and later was picked up by the hygienist to re-insert in the patient’s mouth but before placing it in the patient’s mouth it stuck my friend which made a small puncture through the latex glove and into the skin. The puncture was very minute and he forced it to bleed and washed it with soap and water a few minutes after the incident.

My question is, is there a chance that my friend maybe contaminated by any viruses e.g. HIV? I find this to be highly unlikely but wanted a medical opinion.

My friend was prescribed the following meds just for precautions Crixivan 2400 mg a day and Combivir 150-300 mg. 2x daily (anti HIV meds). Is this going overboard or not? My friend was prescribed these meds for 1 mo and he is young and in good health. Are there any long term side effects if only used for 1 month?

Any suggestions or opinions would be much appreciate it

 

[bananaface]

This forum is not intended to dispense personal medical advice to laypeople.

If your friend has concerns about the appropriateness of his treatment, he or she should seek the opinion of another physician. For questions about the medications he or she is taking, the dispensing pharmacist should be consulted.

Also, posting the same item on multiple forums is not permitted on this site.

 

[deschutes]

Have you tried the Internal Medicine forum? 🙂 They will probably know more about HIV prophylaxis.

No online advice will be a substitute for seeing a real doctor.

I don't know what occupational health & safety procedures are in place at this friend's place of work, but where I am if a healthcare worker gets stuck I believe there would be confidential source testing done on the patient.

 

[deschutes]

This forum is not intended to dispense personal medical advice to laypeople.

If your friend has concerns about the appropriateness of his treatment, he or she should seek the opinion of another physician. For questions about the medications he or she is taking, the dispensing pharmacist should be consulted.

Also, posting the same item on multiple forums is not permitted on this site.

You're right. My brainfart. I retract my previous post!

 

[LADoc00]

I am in need for some assistance regarding a medical incident.

A friend of mine is a dental hygienist who recently was stuck by in instrument that is placed in the patient’s mouth to measure the depth of cavity. The instrument is not very sharp but with minimal force it can puncture the skin. The patient had some lacerations and ulcers in his mouth which maybe indicative of HIV infection but the patient denied any disease. In short, the instrument was originally used on the patient and was left unused for approximately 20 minutes and later was picked up by the hygienist to re-insert in the patient’s mouth but before placing it in the patient’s mouth it stuck my friend which made a small puncture through the latex glove and into the skin. The puncture was very minute and he forced it to bleed and washed it with soap and water a few minutes after the incident.

My question is, is there a chance that my friend maybe contaminated by any viruses e.g. HIV? I find this to be highly unlikely but wanted a medical opinion.

My friend was prescribed the following meds just for precautions Crixivan 2400 mg a day and Combivir 150-300 mg. 2x daily (anti HIV meds). Is this going overboard or not? My friend was prescribed these meds for 1 mo and he is young and in good health. Are there any long term side effects if only used for 1 month?

Any suggestions or opinions would be much appreciate it

Contrary to popular notion, getting HIV from a single needle stick type injury is not easy even if the person was HIV and not being treated. In today's world where viral loads of HIV+ are super low to undetectable due to triple therapy, it is almost impossible save for being injected with a large amount of that person's blood. And this is an instrument, not even a needle. The risk of contracting Hep C from a needle is hundreds of times more likely and those drugs wont do crap against it.

Sooooo Yes, your friend is exposing themselves to a very toxic therapy with pretty much no reason. The EM doc who told them to do this is basically a ******, you can quote me on that.

I have spoken, may anyone who disagrees with me face wrath.

 

[GrandMasterB]

LADoc00's wrath notwithstanding.... 😀 some of what has been said in this thread is right and some is wrong. When someone has a bodily fluid exposure some of the important things to find out are:

1. HIV stats of patient
2. source of fluid (blood, oral secretions, vomitus, urine etc- some are more dangerous than others)
3. mechanism of exposure (splash, puncture etc)
a. stick?- hollow bore needle vs. solid bore, vs other instruments
b. how bloody was the instrument/ guess at the innoculum (sp)
4. length of exposure (splash mainly)
5. body area exposed (eyes, broken skin etc)
6. viral load
7. Hepatits serologies
8. and more i cant think of right now.

Is it impossible to get HIV in this scenario? No. Is it likely? Hard to say given the info provided. The public perception of how risky it is to get stuck with a needle is irrelevant. It is true that the risk for converting to HIV + and Hep C status differs due to the fact that Hep C requires a lower innoculum than HIV for infection, but there are a number of other factors to consider as well; hep C is only transmitted via blood, Hep B is even more infectious than Hep C, etc. Furthermore, there is data regarding risk of becoming infected with HIV, Hep C etc based on mechanisms of exposure and a number of other factors. An ID doc (along with the needle stick coordinator/whoever deals with this sort of stuff at your facility) should be able to provide lots more info.


I think the main thing is to speak with the physician giving the meds, and express your concerns. make sure to get baseline HIV/Hep C/Hep B labs, and follow up those labs after the window period is over.

And just a point for Mr. LacDoc- while triple therapy is great, many patients aren't on it, some don't tolerate it, some don't comply, and some are refractory to treatment- so I have seen plenty of patients with extremely high viral loads- so as Method man might say- "protect yo neck!" 😎

Contrary to popular notion, getting HIV from a single needle stick type injury is not easy even if the person was HIV and not being treated. In today's world where viral loads of HIV+ are super low to undetectable due to triple therapy, it is almost impossible save for being injected with a large amount of that person's blood. And this is an instrument, not even a needle. The risk of contracting Hep C from a needle is hundreds of times more likely and those drugs wont do crap against it.

Sooooo Yes, your friend is exposing themselves to a very toxic therapy with pretty much no reason. The EM doc who told them to do this is basically a ******, you can quote me on that.

I have spoken, may anyone who disagrees with me face wrath.

 

[bananaface]

Contrary to popular notion, getting HIV from a single needle stick type injury is not easy even if the person was HIV and not being treated. In today's world where viral loads of HIV+ are super low to undetectable due to triple therapy, it is almost impossible save for being injected with a large amount of that person's blood. And this is an instrument, not even a needle. The risk of contracting Hep C from a needle is hundreds of times more likely and those drugs wont do crap against it.

Sooooo Yes, your friend is exposing themselves to a very toxic therapy with pretty much no reason. The EM doc who told them to do this is basically a ******, you can quote me on that.

I have spoken, may anyone who disagrees with me face wrath.

The reason i don't like your post is that it encourages the guy to quit the meds. That is between him and his personal physician. It's probably NOT an ER doc, as they would tend to prescribe a Z-pack and refer to a PCP for a followup. Our noses don't belong in this mess.

 

[DrMom]

This forum is not intended to dispense personal medical advice to laypeople.

If your friend has concerns about the appropriateness of his treatment, he or she should seek the opinion of another physician. For questions about the medications he or she is taking, the dispensing pharmacist should be consulted.

Also, posting the same item on multiple forums is not permitted on this site.

closing for reasons stated above.