HIV or HCV or HBV prevents you from practicing?

[Justianna Artz]

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What if you're a resident, and you get a needle stick or something, and unfortunately, you do contract HIV or HCV or HBV or some other blood borne disease. Can the program now kick you out because you are at risk of contaminating patients?

 

[surg]

As I recall, you are going into a surgical field (plastics right?) so the answers are different. At least 1 case I can recall in Philadelphia where an HIV+ surgeon had his privileges revoked and despite suing for protection under the American with Disabilities Act (which specifically lists HIV as a disability), losing his privileges on the basis of his threat to the public health.

For a sobering view from this month's bulletin of the American College of Surgeons ...
<a href="http://www.facs.org/fellows_info/bulletin/perry0302.pdf" target="_blank">http://www.facs.org/fellows_info/bulletin/perry0302.pdf</a>

Moral of the story: watch those sharps!

 

[johnM]

If you do suffer an HIV infection from a needlestick, is the hospital or school required to pay for your treatment? Like workers comp. or something? Or do they just kick you out, $100k+ in debt, banned from practicing medicine, and paying for your own drugs... 🙄

 

[ckent]

•••quote:•••Originally posted by johnM:
•If you do suffer an HIV infection from a needlestick, is the hospital or school required to pay for your treatment? Like workers comp. or something? Or do they just kick you out, $100k+ in debt, banned from practicing medicine, and paying for your own drugs... 🙄 •••••The hospital is required to pay for you HIV treatment/screening (which will come out to a significant dollar figure if you are positive), but they will not pay you for "lost income". That's what disability insurance is for, there are specific disability insurances that cover HIV infection that will pay you some set amount annually if you become infected. You can continue practicing after you become HIV infected, but you may lose the ability to do certain procedures depending on the hospital.

If you do have a needle stick injury, it is very important that you call your stick hotline and get tested immediately. The hospital will want to test you for HIV even though you were just stuck in order to see if you actually had HIV prior to being stuck. It's a liability issue for them, but it is beneficial for you if there is no dispute over whether or not you were actually infected from you needle stick. Also, they will offer to contact the patient whose blood may have been on the needle and ask the patient to disclose whether or not they would consent to an HIV test. If they are positive or test positive, you can still take HIV drugs that will significantly decrease your chances of becoming infected.

 

[AtYourCervix]

fyi...i work in a hospital and from what i understand, there has never been an instance where an HIV infection can be traced back to a needlestick. this is not true for hep c or hep b.

dukegirlie :wink:

 

[maccloud]

•••quote:•••Originally posted by DukeGirlie:
•fyi...i work in a hospital and from what i understand, there has never been an instance where an HIV infection can be traced back to a needlestick. this is not true for hep c or hep b.

dukegirlie :wink: •••••OK then, so back to the original poster's question: what happens if you get, or even already have, HCV or HBV? The law seems to have a lot of protection of HIV victims (the movie Philadelphia comes to mind), but not for HCV or HBV victims. So are there any laws saying that you cannot practice medicine if you have HCV/HBV? Or are there any hospitals that would kick you out as soon as they found out?

 

[ckent]

•••quote:•••Originally posted by DukeGirlie:
•fyi...i work in a hospital and from what i understand, there has never been an instance where an HIV infection can be traced back to a needlestick. this is not true for hep c or hep b.

dukegirlie :wink: •••••Well, I don't think that this is true, I think that there have been a lot of documented cases of HIV transmission with a needle stick. The probability of getting infected after having a needle stick accident from an HIV patient is exceedingly low though. If you do have have a needle stick accident, the probability of being infected (if the patient is infected) is:
0.3% for HIV
3% for HCV
30% for HBV (if you haven't been immunized already)

 

[johnM]

how do you get immunized for HBV?? Is this something that we should be doing?

 

[Kirk]

There is a HBV immunization- it is a series of three shots. The Army gave me these shots about 7 or 8 years ago... Does anyone know if a booster is needed?

Kirk

 

[chef]

so, are you allowed to practice medicine/surgery if you have HBV/HCV/HIV?

or is that illegal?

 

[squeek]

No booster is needed for the HBV. Your medical school or hospital should be vaccinating you--I worked at a hospital prior to medical school, and they required it of all employees, from the secretaries to the attendings. After the series is complete, they draw titers to determine whether you are immune or not.

As far as practicing with active Hep B infection, I do not think it is allowed, due to how contagious it is. In fact, some places have had e-antigen-negative health care workers infect patients, due to a Hep B variant that does not produce e-antigen, and so e-negative Hep B carriers are required to have their viral loads assessed.

I don't know what the HIV/HepC guidelines are, although I can imagine that there is HUGE liability for an infected individual who does not disclose, if a patient happens to get infected.

 

[lilycat]

•••quote:•••Originally posted by DukeGirlie:
•fyi...i work in a hospital and from what i understand, there has never been an instance where an HIV infection can be traced back to a needlestick. this is not true for hep c or hep b.

dukegirlie :wink: •••••Unfortunately that's not true. My med school compassion in medicine elective actually had a doctor who had contracted HIV from a needle stick come talk to us. She's been HIV+ for about 10 years now, but she's starting to run out of effective drug cocktail options so the reality is that she is facing full-blown AIDS within the next couple of years.

 

[tulanestudent]

ckent's numbers are right from all i've read, but these are mostly for "open-bore needles", like if you drew someone's blood, then stuck yourself with the needle. The risk for, say, a suture needle, is less. This is intuitive, b/c there is much less blood volume transmisible on a suture needle vs. an open-bore needle.

Your school should be vaccinating you for hep B. Some elementary schools are even beginning to require this vaccine for kids to attend in some states, so hopefully soon everyone will be vaccinated somehow.

I can't imagine that any of these would keep people from practicing medicine in non-bloody specialties. If I had one of these viruses, I think I would avoid a surgical field, as I would not want to chance putting my patients at risk should an accident happen. However, there would be very low risk of a psychiatrist giving a bloodborne virus to a patient. There are plenty of medical specialties that do not involve needles, so there would be no need to fear loosing medical privileges entirely.

 

[12R34Y]

you may actually need to get an HBV booster.........I had immunity for several years after my shots, but this last year my titer levels were low. I had to get an HBV booster. So, yes you may need a booster. you should get a titer level drawn every year to see if you have immunity.

later

 

[grissyfluvin]

Actually, a friend of mine is a surgical resident, and he has HBV contracted from a blood transfusion many years prior. Apparently, he's allowed to work there and he has been forthright with his blood history. I can check on more details if the original poster or anyone else is still interested in this topic.