Razor Cut

[Romans51]

Good morning,

I'm a police officer in Canada. I recently responded to a call of a pregnant suicidal female in a residence. She attempted to barricade herself in the bathroom, which she was unsuccessful. Blocking the door with my foot, I looked in and she was slicing her neck open with a razor blade. I was able to wrestle the blade from her, but in the process, sliced my finger open with said razor.

The wound would bleed slightly, and I would immediately wash it out with hydrogen peroxide, followed by alcohol swabs by the EMS services. The woman and her boyfriend would confirm they are both clean (No HIV, Hep etc). But, of course, I'm doing blood tests for the next year.

How long would it take before I know for certain that I wasn't exposed (Blood tests are 1 month, 3 month, 6 month, 1 year)? Her blood has already been drawn as she consented to the procedure (we had a little chat).

Thanks for your help.

Roman

[Romans51]

From what I understand, the woman or boyfriend did not have any history of drug abuse. The boyfriend actually seemed pretty on the level and stated that he had been tested not too far in the past.

My Hep B and Tetanus shots are up to date according to the health services officer in the region.

Thanks for your prompt response.

Sincerely,

Roman

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Dear Roman,

First, thank you for your continued service as a law enforcement officer.

Now to your questions.

Epidemiological studies have indicated that the average risk of HIV transmission after percutaneous (passing through the skin) exposure to HIV infected blood in health care settings is about 3 per 1,000 injuries. The risk of contracting Hepatitis C is

1. How long would it take before I know for certain that I wasn't exposed (Blood tests are 1 month, 3 month, 6 month, 1 year)?
In general, if the "source" patient is negative for Hep C and HIV, you have a very small but not zero risk of infection. There exists a "window" when a person may have virus in their blood stream but not antibodies to the virus(es) (what the standard tests in the laboratory test for). This time period is commonly referred to as the “window period”. Most people will develop detectable antibodies within 2 to 8 weeks (the average is 25 days). Even so, there is a chance that some individuals will take longer to develop detectable antibodies.The decision for follow-up testing in a negative source patient is based upon assessment of the risk of the source patient (whether or not it is likely that they could have recently been exposed to HIV or Hep C in the prior few weeks and what the actual viral load is).

2. At 4 weeks, the certainty of the testing is estimated at 50-60%; at 3 months, the certainty of the testing is >90%; at 6 months, the certainty of the testing is ~99%; at 9 months, the certainty of the testing is >99%, and 1 year, the certainty of the testing is ~99.9% (unfortunately, there are few tests in medicine that are 100% certain).

A couple questions from me:

Did the woman or her boy friend have a history of drug abuse? She likely has had a recent HIV test if she is getting prenatal care as part of her pregnancy.

Just to make sure, is your tetanus up-to-date?
What about your Hepatitis B vaccination status?

Please respond with additional questions.

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.