Possible Occupational Exposure

[PanicStricken]

On 4/26/06 a bloody sheet that was under and next to an emergency patient might have contacted some areas of eczema on my arms while I was moving the patient. The blood might have been starting to dry because it was brownish red. I had forgotten about the areas on my arms because although itchy every now and then, the eczema was not running or bleeding. There was however burning with alcohol.
     I already know about universal precautions, but there was very little notice with this emergency case. On 6/21/06 which is 56 days or 8 weeks later, I started having muscle aches that came and went and changed places, from hips, thighs, forearms, upper arms etc., but were more constant in the lower part of my legs. I also had somewhat enlarged painful lymph nodes mostly just around my neck along with some streaking pains in my head and my ears that came and went intermittently. I had the symptoms off and on until about 7/7. Starting about 7/10, I noted a rash on my chest. It didn

[PanicStricken]

This is to update everyone. I had an OraQuick Advance Rapid HIV-1/2 oral swab test on 10/10/06, 167 days from the possible exposure. The test was negative. After worrying about whether I swabbed correctly or sufficiently, I went on 10/11, 168 days from possible exposure, and took a rapid HIV-1 blood test. That test was also negative. The only thing that concerns me now is if I received an HIV/Hepatitis co-infection which might lengthen the HIV window period out to 12 months.

[H. Hunter Handsfield, M.D.]

First, relax.  There is no chance you acquired HIV during the event you describe.  If such exposure could transmit the virus, the infection would be 100 times more common than it is.

Second, the proper source for the answers to all your questions is the employee health service and/or the hospital's infection control staff.

My brief responses are that you really did not have an exposure at all; there is no chance you acquired HIV from the event, and testing probably was not necessary.  You might assume that "just one virus" is all it takes to get HIV, but that is wrong.  It requires exposure to large amounts of virus directly inside your body, far more virus than is conceivable by touching drying blood, even with eczema.  Your negative test result 11 weeks later is 100%; see my numerous other responses seroconversion time (search "time to positive HIV test").  Since you could not have acquired HIV and the test shows you do not have it, your symptoms simply cannot be due to HIV, period.  Anyway, symptoms never are a reliable indicator of early HIV infection in low-risk settings.  (Search for "ARS symptoms" and "HIV symptoms".)
And no, they don't sound much like ARS anyway.  Your temperature is normal.

So mellow out and stop worrying about this non-event.  If you have not seen your employee health service about this, call and visit with them and follow their advice.  Let's not get into a string of "yes but" or "what if" questions.  There is no information you could provide that would change my opinion or advice.

Best wishes---   HHH, MD