Hello doc, I hope my message finds you in good health. I am a post graduate dentist working at a teaching hospital in UK. 8 weeks ago, I got pricked on my finger with an endodontic instrument. The finger didnt bleed, the endodontic instruement was being used during a root canal treatment and before I got pricked, it was picked from hydrogen peroxide solution.
Just for the sake of it, I requested the patient to get test for HIV and also requested him to do his hepititus profile. He was negative. The tests performed were 4th generation.
Then I got myself tested a month after the needle stick injury. The tests was 4th generation ELISA. It was negative. The cut-off rate was 1.00 and my value was 0.10. I again for myself tested 8 weeks after the incident and the 4th generation ELISA was again negative. My value was 0.20.
My question is ... why my values increased from 0.10 to 0.20 ? Is there anything to worry about ? Are 4th generation ELISA accurate enough ? What do you suggest, Im simply getting worried as I know about the disease itself.
You have nothing to worry about. First, the "poke" didn't even result in a break in the skin. Second of all, superficial needle sticks virtually NEVER EVER result in infection, it is extremely rare. The type of occupational exposures that would be more likely to lead to transmission would be where there is a significant injury with exposure to a LARGE amount of fresh blood (think of an OR situation with a scalpel injury and a pt hemorrhaging). At one of my prior jobs, I helped out a lot in the infectionl control dept, and out of a few needle exposures with pt's + for varying illnesses (Hepatitis, one HIV, etc)...there was never a transmission. These were typical superficial needle pokes.
Secondly, the patient tested negative. There is your proof if you doubt the exposure. You cannot be infected if the person has nothing to infect you with!!
I would advise you to continue your education about blood borne pathogens, and TRUE risks, which are usually misunderstood. Always follow your facility (office) procedure post an "exposure", as every health care facilty DOES have a post-exposure protocol in place.
Good luck in your future career. Speaking as a HUGE dental sissy....please always be compassionate with your patients...and offer as many MIND numbing (not tooth numbing, lol) drugs as you can for procedures. Trust me, it is appreciated! ;0)
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