How safe is HIV research?

[Gut Shot]

Everything I presented was based off of facts

Really? It's a fact that feces are the only substance ever found in the rectum?

Theoretical discussions are not fully applicable to real-life situations due to the fact that real-life situations present a combination of things (sometimes unexpected). But none of the things you suggested really present real-life risks anyway...

The rectal sharp scenario was drawn from experiences in the hospital where I did the bulk of my residency training. The issue isn't so much that a single even is particularly risky, it's that there are millions of potentially risky events happening every day, and there is hell to pay when the system fails (which is inevitable). Consider HIV transmission by blood transfusion. The risk is approximately 1 in 1.8 million. How many units of blood are given every year?

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[Gut Shot]

Also, I looked up the bush meat theory. Someone got infected with an SIV virus, which later formed into a strain of HIV. This doens't make for good comparison unless you know exactly how infectious the SIV virus is compared to HIV.

First off, the V in SIV stands for "virus," so "SIV virus" is redundant (like ATM machine).

Second, the fact that SIV is a zoonotic virus, and that it shares only about 50% homology with HIV-1, strongly suggest the leap wasn't easy.

 

[shoehornlettuce]

Don't forget about the friend who set remote mines behind a door and then told you there was body armor in the room...

Ha ha, my buddy would always load those red hallways in the facility with remote mines and then sit in the rafters above the toilets and screen read. As soon as a blip of red showed up on somebodies screen the mines went off.

 

[sportsperson]

Really? It's a fact that feces are the only substance ever found in the rectum?



The rectal sharp scenario was drawn from experiences in the hospital where I did the bulk of my residency training. The issue isn't so much that a single even is particularly risky, it's that there are millions of potentially risky events happening every day, and there is hell to pay when the system fails (which is inevitable). Consider HIV transmission by blood transfusion. The risk is approximately 1 in 1.8 million. How many units of blood are given every year?

The feces was a single statement, basically saying that by touching feces alone (purely hypothetical) then it won't mean anything in terms of HIV.

Sharps in the rectum? It's already been mentioned that sharps present you to a risk. So no need discuss that any further.
And I don't see your point about blood transfusions. Yes there is a risk but many things in life are much riskier... and my point is that you should be more concerned about those things first before nitpicking tiny risks.

First off, the V in SIV stands for "virus," so "SIV virus" is redundant (like ATM machine).

Second, the fact that SIV is a zoonotic virus, and that it shares only about 50% homology with HIV-1, strongly suggest the leap wasn't easy.

When typing fast you don't always think about every word, hence how typos happen.

The leap probably wasn't difficult, but how infectious is SIV environmentally?

 

[Gut Shot]

and my point is that you should be more concerned about those things first before nitpicking tiny risks.

I don't find that awareness is tantamount to "nitpicking tiny risks."

The leap probably wasn't difficult,

What is your rationale for this statement?

 

[CoolWhipp]

I don't find that awareness is tantamount to "nitpicking tiny risks."



What is your rationale for this statement?

After work hours and still medical student pimping are we?

 

[deleted103644]

First off, the V in SIV stands for "virus," so "SIV virus" is redundant (like ATM machine).

Second, the fact that SIV is a zoonotic virus, and that it shares only about 50% homology with HIV-1, strongly suggest the leap wasn't easy.

I haven't read all of what the other guy has written so won't defend it, but you're being a little hyperbolic yourself.

Of course HIV comes from SIV, but the transmission rates for SIV to humans are even lower - to start the HIV epidemic it only had to happen once.

There are many things that can happen rarely that just aren't worth worrying about on an individual level. Epidemiologically? Sure.

You're doing a disservice by trying to make people disproportionately worried about HIV. Proper protective measures should be used, but frankly if someone comes in with HIV and TB, you should be more worried about the TB (etc, etc).

At this point, HIV patients are mainly dangerous from the perspective that they are incubators for all sorts of other nasty things that might be able to catch the occasional susceptible individual unawares.

An HIV patient with a high CD4 count and low viral titer? Really not someone to be too worried about treating...

I remain more worried about HCV (and TB), even though they carry a less definitive death sentence when left untreated. (With treatment, it's much worse to have MDR TB or HCV than HIV.)

 

[Gut Shot]

You're doing a disservice by trying to make people disproportionately worried about HIV.

I only dropped in here because someone didn't seem fully aware of the magical world of rectal contents. We could replace HIV with any other infectious entity and my perspective would be the same: you never know what's going to come waltzing into your clinic, so be prepared before shoving your hand up in it, because crazy things happen every day.

 

[sportsperson]

I don't find that awareness is tantamount to "nitpicking tiny risks."



What is your rationale for this statement?

That was a typo. It was difficult.

 

[Itwashambone]

.

 

[deleted103644]

I only dropped in here because someone didn't seem fully aware of the magical world of rectal contents. We could replace HIV with any other infectious entity and my perspective would be the same: you never know what's going to come waltzing into your clinic, so be prepared before shoving your hand up in it, because crazy things happen every day.

Ah, in that case, my apologies. I think you went a bit too far in the other direction while making your argument though... (came across as "only one glove for a DRE on an HIV patient = death")

 

[Gut Shot]

Ah, in that case, my apologies.

No worries.

I think you went a bit too far in the other direction while making your argument though... (came across as "only one glove for a DRE on an HIV patient = death")

Have you ever had an exposure?

 

[deleted103644]

No worries.



Have you ever had an exposure?

Define exposure.

Fluids in an open wound or a sharp accident? No.

I've definitely worked with HIV patients.

 

[addo]

LOL at the whole ****ing thread

 

[Gut Shot]

Define exposure.

Fluids in an open wound or a sharp accident? No.

I've definitely worked with HIV patients.

Yes, sharps exposure, and it was a doozy. I can assure you that it's a delightful experience. You begin by analyzing the stupidity/avoidable nature of every action leading up to the exposure. If your hand was an inch to the left, if you hadn't been in such a hurry, if you'd just followed the damned protocol more closely. Your attendings try to make you feel better by telling you about the exposures they had while in training, but it doesn't really help.

It's a bit like looking at all the infuriatingly avoidable events that led up to the sinking of the RMS Titanic, only on a more personal level.

Then you start looking at the patient whose blood you were exposed to. I was fortunate to be in a relatively ritzy private hospital when I stabbed myself. In my case the patient was a seemingly normal older, middle class man. But could he have been a recovered IV drug user? He looked about the right age for Woodstock. Did he have secret high risk lifestyle he was hiding his from his family?

What if this had happened at County, which is crammed with drug abusers and HIV-positive people?

I apologize if this seems melodramatic, but after your first real stick you don't look at risk management quite the same way.