needle stick

[needlestick]

Hi Doctor Edward/ Doctor Hunter,

I was sticked by a needle which was left abundant while I was clearing rubbish outside the compound of my house. The needle was somewhere beneath or beside a rubbish beg. I was sticked when I pushed a rubbish beg. I am not sure whether injection involved but I observed some liquid in the needle. (not sure there was blood).

I was there over 10 minutes and I am sure the needle was abundant minimum after 10 to 15 minutes. At first I ignored it as I learned from this forum (Teak, Vance, Lizzy) before that hiv virus is not active and thus not infectious outside its host. I started to worry when I recalled that most hiv transmission is due to sharing needle amongst iv drug user.

My question is whether hiv virus still infectious in a needle for more than 10 minutes outside its host? I guess transmission amongst drug user who share needle is due to immediate sharing without gap of time and therefore virus still active and infectious. worrywort mentioned that the risk is 0.003% and transmission to healthcare worker is due to the fact that doctor or nurse pricked themselfs right away while drawing blood from patient.

1) am I at risk of hiv? 2) is my point valid? 3) is worrywort correct?

[Edward W Hook, MD]

No, the tests are the important fact.  No change in my assessment. EWH

[needlestick]

Hi Doctor, Sorry to bother you again but I have some fact to inform you. I knew from my neighbour that there are a few drug addicts who share needle around that area and one of them died of aids last year. Most probably the needle was abundant by them. Doctor, will that change your opinion that I can be sure of my negetive hiv combo result?

An expert from another forum warned that for p24 antigen test, not everone's viral strain or immune response is identical. So doctor, just to clarify with you how many % of newly hiv infected people will not develop p24 antigen by 28 days? Doctor, feel free to close this threat if my question not warranted. Thanks a lot.

[Edward W Hook, MD]

The combo is the same as the DUO.  You do not need further testing.  EWH

[needlestick]

Dear beloved Doctor, Thank you for your helpful information. I did a Combo ab/ag test (AxSym) on day 28 but short of 6 hours. Result negetive. I am so happy now.

Do I need further test as I am not sure combo is the same as duo? or I can just rest in peace with my 28 days negative forever?

Thanks with love.

[needlestick]

Thanks Doc, with this info I think I must be ok. The temparature was about 24 to 28 degree. I will go for a hiv test (with p24 antigen) on 2nd october and will post my result. Thanks with Love.

[Edward W Hook, MD]

1.  A combined "DUO" (combination HIV p24 antigen/HIV antibody) test at 4 weeks after your needle stick will provide definitive answer.  I expect it will be negative.

2.  Pleasee re-read my answer.  if conditons are correct with the virus maintained in a moist warm environment it MIGHT still be infectious.  That said, I would not worry that it might have been, even if HIV was present (which, as I said before is unlikely)

EWH  

[needlestick]

Hi Doctor Edward,

I promise not to ask further question. Just need you professional advice before I go for the next step.

1) what test do you suggest and when?
2) do you really think hiv virus can still infect people after leaving its host for more than 15 minutes? I mean in the needle.

Please doctor, I really need this and is final. God bless.

[needlestick]

Thanks Doctor, 72 hours had elapsed. Nothing I can do now. I am not sure who was the user of the needle and what is the liquid (white colour).

By now hiv testing is the only way I guess so doctor, what type of test I can go for? Earliest?

I read from the forum that hiv is not infectious outside its host but in my case, why it is still possible for infection? Doctor even mentioned that there is no risk eventhough genital secretion is used as lubricant for external sex?

I mentioned 10 to 15 minutes because I was there for over 10 to 15 minutes and if someone abundant the needle, it must be at least 10 to 15 minutes ago before the final user of the needle abundant it? Meaning that if the material contained hiv virus, the virus must be out of the host for at least 10 to 15 minutes and logically, it should be even longer?

[Edward W Hook, MD]

Welcome to our Forum.  Your risk of HIV from a needle stick injury is low but it is difficult to say just how low because there are many variables that affect the risk of infection.   Do you know where the needle came from or who had used it before you were stuck?  Why do you mention 10 minutes?  Do you think any of the material in the needle could have been injected into you?

The factors which impact risk of infection, besides the obvious questions of whether the person who had used the needle previously was infected include the size of the needle, how long it had been outside after being used and whether there was moisture in the needle that might allow the virus to live longer than it would in a dry environment.  You mention that there was liquid in the needle- do you know what this was.

As I said to start out, overall your risk of infection is quite low.  The chance that it came from a person who had HIV is low and the chance of infection in the situation you describe is low but not zero.  This is a situation in which many health care providers would at least discuss the possibility of PEP but know more about the situation would help.  As you consider this, I would also point out that the sooner you make these decisions the better for you. There is no evidence that PEP is helpful if more than 72 hours has passed since the exposure.  EWH

EWH